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Chen ML, Li XT, Wei YY, Qi LP, Sun YS. Can spectral computed tomography imaging improve the differentiation between malignant and benign pulmonary lesions manifesting as solitary pure ground glass, mixed ground glass, and solid nodules? Thorac Cancer 2018; 10:234-242. [PMID: 30582292 PMCID: PMC6360238 DOI: 10.1111/1759-7714.12937] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This study quantitatively assessed the efficacy of spectral computed tomography (CT) imaging parameters for differentiating the malignancy and benignity of solitary pulmonary nodules (SPNs) manifesting as ground glass nodules (GGNs) and solid nodules (SNs). METHODS The study included 114 patients with SPNs (61 GGNs, and 53 SNs) who underwent CT plain and enhanced scans in the arterial (a) and venous (v) phases using the spectral imaging mode. The spectral CT imaging parameters included: iodine concentrations (IC) of lesions in the arterial (ICLa) and venous (ICLv) phases; normalized IC (NICa/NICv, normalized to the IC in the aorta); the slope of the spectral Hounsfield unit (HU) curve (λHUa/λHUv); and monochromatic CT number (CT40keVa/v, CT70keVa/v) enhancement on 40 and 70 keV images. The two-sample Mann-Whitney U test was used to compare quantitative parameters between malignant and benign SPNs, SNs, and GGNs. RESULTS Pathology revealed 75 lung cancer cases, 3 metastatic nodules, 14 benign nodules, and 22 inflammatory nodules. Among the 53 SNs there were 37 malignant and 16 benign nodules. Among the 61 GGNs there were 41 malignant and 20 benign nodules. Overall, the CT40keVa, λHUa, CT40keVv, λHUv, and ICLv of benign SPNs were all greater than those of malignant SPNs (all P < 0.05). For GGNs, CT40keVa/v, CT70keVa/v, λHUa/λHUv, and ICLv of malignant GGNs were all lower than those of benign GGNs. CONCLUSION Spectral CT imaging is a more promising method for distinguishing malignant from benign nodules, especially in nodules manifesting as GGNs in contrast-enhanced scanning.
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Affiliation(s)
- Mai-Lin Chen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiao-Ting Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yi-Yuan Wei
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Li-Ping Qi
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Ying-Shi Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China
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Spectral CT Analysis of Solitary Pulmonary Nodules for Differentiating Malignancy from Benignancy: The Value of Iodine Concentration Spatial Distribution Difference. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4830659. [PMID: 30627561 PMCID: PMC6304588 DOI: 10.1155/2018/4830659] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/23/2018] [Accepted: 11/21/2018] [Indexed: 12/17/2022]
Abstract
Objective The objective is to assess the value of spatial distribution difference in iodine concentration between malignant and benign solitary pulmonary nodules (SPNs) by analyzing multiple parameters of spectral CT. Methods Sixty patients with 39 malignant nodules and 21 benign nodules underwent chest contrast CT scans using spectral imaging mode during pulmonary arterial phase (PP), arterial phase (AP), and venous phase (VP). Iodine concentrations of proximal and distal regions in pulmonary nodules on iodine-based material decomposition images were recorded. Normalized iodine concentration (NIC) and the differences in NIC between the proximal and the distal regions (dNIC) were calculated. The two-sample t-test and Mann-Whitney U-test were performed to compare the multiple parameters generated from spectral CT between malignant and benign nodules. Receiver operating characteristic (ROC) curves were generated to calculate sensitivity and specificity. Results NIC in the proximal region (NICpro) and NIC in the distal region (NICdis) between malignant and benign nodules at AP (NICpro, P=0.012; NICdis, P=0.024), and VP (NICpro, P=0.005; NICdis, P =0.004) were significantly different. NICpro at PP (P = 0.037) was also found significantly different between malignant and benign nodules; however, no significant differences were found in NICdis at PP (P = 0.093). In addition, the dNIC of malignant nodules was significantly higher than that of benign ones at PP (median and interquartiles (0.31, 0.11, 0.57 versus -0.26, -0.5, -0.1); p≤0.001), AP (mean dNIC, 0.093 ±0.094 versus -0.075±0.060; p≤0.001), and VP (mean dNIC, 0.171±0.137 versus -0.183±0.127; p≤0.001). The sensitivity and specificity (93%, 95%, respectively) of dNIC during VP were higher than other parameters, with a threshold value of -0.07. Conclusions Spectral CT imaging with multiple parameters such as NICpro, NICdis, and dNIC may be a new method for differentiating malignant SPNs from benign ones.
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He L, Niu L, Korpan NN, Sumida S, Xiao Y, Li J, Sutedja B, Lu Y, Zuo J, Liu J, Xu K. Clinical Practice Guidelines for Cryosurgery of Pancreatic Cancer: A Consensus Statement From the China Cooperative Group of Cryosurgery on Pancreatic Cancer, International Society of Cryosurgery, and Asian Society of Cryosurgery. Pancreas 2017; 46:967-972. [PMID: 28742542 PMCID: PMC5555970 DOI: 10.1097/mpa.0000000000000878] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 06/08/2017] [Indexed: 12/12/2022]
Abstract
Pancreatic cancer (PC), one of the most lethal malignancies, accounts for 8% to 10% of digestive system cancers, and the incidence is increasing. Surgery, chemotherapy, and radiotherapy have been the main treatment methods but are not very effective. Cryosurgery was first used in 1984 for treatment of locally advanced PC and has since become a considerable treatment for most cases of unresectable PC. During the past decade, cryosurgery has been applied in some hospitals in China, and the newly developed technique of computed tomography- and/or ultrasound-guided percutaneous cryosurgery has shown better results than chemotherapy in cases of unresectable locally advanced PC, with the 1-year survival rate reported to be more than 50%. To develop standardized criteria for the application of cryosurgery in PC, the International Society of Cryosurgery and Asian Society of Cryosurgery assembled experts from Austria, Japan, and China to discuss treatment methods and arrive at a consensus on the indications, contraindications, and preferred techniques of PC cryosurgery.
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Affiliation(s)
- Lihua He
- From the *Department of Oncology, Fuda Cancer Hospital, Jinan University School of Medicine, Guangzhou, China; †International Society of Cryosurgery, Austria Society of Cryosurgery, International Institute for Cryosurgery, Vienna, Austria; ‡International Society of Cryosurgery, Japan Society for Low Temperature Medicine, Tokyo, Japan; §Asian Society of Cryosurgery; PLA General Hospital, Beijing; and ∥Oncological Intervention Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; ¶Indonesian Society of Cryosurgery, Jakarta, Indonesia; and #Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - Lizhi Niu
- From the *Department of Oncology, Fuda Cancer Hospital, Jinan University School of Medicine, Guangzhou, China; †International Society of Cryosurgery, Austria Society of Cryosurgery, International Institute for Cryosurgery, Vienna, Austria; ‡International Society of Cryosurgery, Japan Society for Low Temperature Medicine, Tokyo, Japan; §Asian Society of Cryosurgery; PLA General Hospital, Beijing; and ∥Oncological Intervention Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; ¶Indonesian Society of Cryosurgery, Jakarta, Indonesia; and #Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - Nikolai N. Korpan
- From the *Department of Oncology, Fuda Cancer Hospital, Jinan University School of Medicine, Guangzhou, China; †International Society of Cryosurgery, Austria Society of Cryosurgery, International Institute for Cryosurgery, Vienna, Austria; ‡International Society of Cryosurgery, Japan Society for Low Temperature Medicine, Tokyo, Japan; §Asian Society of Cryosurgery; PLA General Hospital, Beijing; and ∥Oncological Intervention Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; ¶Indonesian Society of Cryosurgery, Jakarta, Indonesia; and #Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - Sajio Sumida
- From the *Department of Oncology, Fuda Cancer Hospital, Jinan University School of Medicine, Guangzhou, China; †International Society of Cryosurgery, Austria Society of Cryosurgery, International Institute for Cryosurgery, Vienna, Austria; ‡International Society of Cryosurgery, Japan Society for Low Temperature Medicine, Tokyo, Japan; §Asian Society of Cryosurgery; PLA General Hospital, Beijing; and ∥Oncological Intervention Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; ¶Indonesian Society of Cryosurgery, Jakarta, Indonesia; and #Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - Yueyong Xiao
- From the *Department of Oncology, Fuda Cancer Hospital, Jinan University School of Medicine, Guangzhou, China; †International Society of Cryosurgery, Austria Society of Cryosurgery, International Institute for Cryosurgery, Vienna, Austria; ‡International Society of Cryosurgery, Japan Society for Low Temperature Medicine, Tokyo, Japan; §Asian Society of Cryosurgery; PLA General Hospital, Beijing; and ∥Oncological Intervention Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; ¶Indonesian Society of Cryosurgery, Jakarta, Indonesia; and #Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - Jiaping Li
- From the *Department of Oncology, Fuda Cancer Hospital, Jinan University School of Medicine, Guangzhou, China; †International Society of Cryosurgery, Austria Society of Cryosurgery, International Institute for Cryosurgery, Vienna, Austria; ‡International Society of Cryosurgery, Japan Society for Low Temperature Medicine, Tokyo, Japan; §Asian Society of Cryosurgery; PLA General Hospital, Beijing; and ∥Oncological Intervention Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; ¶Indonesian Society of Cryosurgery, Jakarta, Indonesia; and #Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - Barlian Sutedja
- From the *Department of Oncology, Fuda Cancer Hospital, Jinan University School of Medicine, Guangzhou, China; †International Society of Cryosurgery, Austria Society of Cryosurgery, International Institute for Cryosurgery, Vienna, Austria; ‡International Society of Cryosurgery, Japan Society for Low Temperature Medicine, Tokyo, Japan; §Asian Society of Cryosurgery; PLA General Hospital, Beijing; and ∥Oncological Intervention Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; ¶Indonesian Society of Cryosurgery, Jakarta, Indonesia; and #Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - Youyong Lu
- From the *Department of Oncology, Fuda Cancer Hospital, Jinan University School of Medicine, Guangzhou, China; †International Society of Cryosurgery, Austria Society of Cryosurgery, International Institute for Cryosurgery, Vienna, Austria; ‡International Society of Cryosurgery, Japan Society for Low Temperature Medicine, Tokyo, Japan; §Asian Society of Cryosurgery; PLA General Hospital, Beijing; and ∥Oncological Intervention Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; ¶Indonesian Society of Cryosurgery, Jakarta, Indonesia; and #Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - Jiansheng Zuo
- From the *Department of Oncology, Fuda Cancer Hospital, Jinan University School of Medicine, Guangzhou, China; †International Society of Cryosurgery, Austria Society of Cryosurgery, International Institute for Cryosurgery, Vienna, Austria; ‡International Society of Cryosurgery, Japan Society for Low Temperature Medicine, Tokyo, Japan; §Asian Society of Cryosurgery; PLA General Hospital, Beijing; and ∥Oncological Intervention Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; ¶Indonesian Society of Cryosurgery, Jakarta, Indonesia; and #Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - Jianguo Liu
- From the *Department of Oncology, Fuda Cancer Hospital, Jinan University School of Medicine, Guangzhou, China; †International Society of Cryosurgery, Austria Society of Cryosurgery, International Institute for Cryosurgery, Vienna, Austria; ‡International Society of Cryosurgery, Japan Society for Low Temperature Medicine, Tokyo, Japan; §Asian Society of Cryosurgery; PLA General Hospital, Beijing; and ∥Oncological Intervention Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; ¶Indonesian Society of Cryosurgery, Jakarta, Indonesia; and #Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - Kecheng Xu
- From the *Department of Oncology, Fuda Cancer Hospital, Jinan University School of Medicine, Guangzhou, China; †International Society of Cryosurgery, Austria Society of Cryosurgery, International Institute for Cryosurgery, Vienna, Austria; ‡International Society of Cryosurgery, Japan Society for Low Temperature Medicine, Tokyo, Japan; §Asian Society of Cryosurgery; PLA General Hospital, Beijing; and ∥Oncological Intervention Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; ¶Indonesian Society of Cryosurgery, Jakarta, Indonesia; and #Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
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Liu Y, Wang H, Li Q, McGettigan MJ, Balagurunathan Y, Garcia AL, Thompson ZJ, Heine JJ, Ye Z, Gillies RJ, Schabath MB. Radiologic Features of Small Pulmonary Nodules and Lung Cancer Risk in the National Lung Screening Trial: A Nested Case-Control Study. Radiology 2017; 286:298-306. [PMID: 28837413 DOI: 10.1148/radiol.2017161458] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Purpose To extract radiologic features from small pulmonary nodules (SPNs) that did not meet the original criteria for a positive screening test and identify features associated with lung cancer risk by using data and images from the National Lung Screening Trial (NLST). Materials and Methods Radiologic features in SPNs in baseline low-dose computed tomography (CT) screening studies that did not meet NLST criteria to be considered a positive screening examination were extracted. SPNs were identified for 73 incident case patients who were given a diagnosis of lung cancer at either the first or second follow-up screening study and for 157 control subjects who had undergone three consecutive negative screening studies. Multivariable logistic regression was used to assess the association between radiologic features and lung cancer risk. All statistical tests were two sided. Results Nine features were significantly different between case patients and control subjects. Backward elimination followed by bootstrap resampling identified a reduced model of highly informative radiologic features with an area under the receiver operating characteristic curve of 0.932 (95% confidence interval [CI]: 0.88, 0.96), a specificity of 92.38% (95% CI: 52.22%, 84.91%), and a sensitivity of 76.55% (95% CI: 87.50%, 95.35%) that included total emphysema score (odds ratio [OR] = 1.71; 95% CI: 1.39, 2.01), attachment to vessel (OR = 2.41; 95% CI: 0.99, 5.81), nodule location (OR = 3.25; 95% CI: 1.09, 8.55), border definition (OR = 7.56; 95% CI: 1.89, 30.8), and concavity (OR = 2.58; 95% CI: 0.89, 5.64). Conclusion A set of clinically relevant radiologic features were identified that that can be easily scored in the clinical setting and may be of use to determine lung cancer risk among participants with SPNs. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Ying Liu
- From the Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; and Tianjin's Clinical Research Center for Cancer, Tianjin, China (Y.L., H.W., Q.L., Z.Y.); and Departments of Cancer Imaging and Metabolism (Y.L., Q.L., Y.B., A.L.G., R.J.G.), Diagnostic Imaging and Interventional Radiology (M.J.M.), Biostatistics and Bioinformatics (Z.J.T.), Cancer Epidemiology (J.J.H., M.B.S.), and Thoracic Oncology (M.B.S.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, MRC-CANCONT, Tampa, FL 33612
| | - Hua Wang
- From the Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; and Tianjin's Clinical Research Center for Cancer, Tianjin, China (Y.L., H.W., Q.L., Z.Y.); and Departments of Cancer Imaging and Metabolism (Y.L., Q.L., Y.B., A.L.G., R.J.G.), Diagnostic Imaging and Interventional Radiology (M.J.M.), Biostatistics and Bioinformatics (Z.J.T.), Cancer Epidemiology (J.J.H., M.B.S.), and Thoracic Oncology (M.B.S.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, MRC-CANCONT, Tampa, FL 33612
| | - Qian Li
- From the Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; and Tianjin's Clinical Research Center for Cancer, Tianjin, China (Y.L., H.W., Q.L., Z.Y.); and Departments of Cancer Imaging and Metabolism (Y.L., Q.L., Y.B., A.L.G., R.J.G.), Diagnostic Imaging and Interventional Radiology (M.J.M.), Biostatistics and Bioinformatics (Z.J.T.), Cancer Epidemiology (J.J.H., M.B.S.), and Thoracic Oncology (M.B.S.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, MRC-CANCONT, Tampa, FL 33612
| | - Melissa J McGettigan
- From the Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; and Tianjin's Clinical Research Center for Cancer, Tianjin, China (Y.L., H.W., Q.L., Z.Y.); and Departments of Cancer Imaging and Metabolism (Y.L., Q.L., Y.B., A.L.G., R.J.G.), Diagnostic Imaging and Interventional Radiology (M.J.M.), Biostatistics and Bioinformatics (Z.J.T.), Cancer Epidemiology (J.J.H., M.B.S.), and Thoracic Oncology (M.B.S.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, MRC-CANCONT, Tampa, FL 33612
| | - Yoganand Balagurunathan
- From the Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; and Tianjin's Clinical Research Center for Cancer, Tianjin, China (Y.L., H.W., Q.L., Z.Y.); and Departments of Cancer Imaging and Metabolism (Y.L., Q.L., Y.B., A.L.G., R.J.G.), Diagnostic Imaging and Interventional Radiology (M.J.M.), Biostatistics and Bioinformatics (Z.J.T.), Cancer Epidemiology (J.J.H., M.B.S.), and Thoracic Oncology (M.B.S.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, MRC-CANCONT, Tampa, FL 33612
| | - Alberto L Garcia
- From the Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; and Tianjin's Clinical Research Center for Cancer, Tianjin, China (Y.L., H.W., Q.L., Z.Y.); and Departments of Cancer Imaging and Metabolism (Y.L., Q.L., Y.B., A.L.G., R.J.G.), Diagnostic Imaging and Interventional Radiology (M.J.M.), Biostatistics and Bioinformatics (Z.J.T.), Cancer Epidemiology (J.J.H., M.B.S.), and Thoracic Oncology (M.B.S.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, MRC-CANCONT, Tampa, FL 33612
| | - Zachary J Thompson
- From the Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; and Tianjin's Clinical Research Center for Cancer, Tianjin, China (Y.L., H.W., Q.L., Z.Y.); and Departments of Cancer Imaging and Metabolism (Y.L., Q.L., Y.B., A.L.G., R.J.G.), Diagnostic Imaging and Interventional Radiology (M.J.M.), Biostatistics and Bioinformatics (Z.J.T.), Cancer Epidemiology (J.J.H., M.B.S.), and Thoracic Oncology (M.B.S.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, MRC-CANCONT, Tampa, FL 33612
| | - John J Heine
- From the Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; and Tianjin's Clinical Research Center for Cancer, Tianjin, China (Y.L., H.W., Q.L., Z.Y.); and Departments of Cancer Imaging and Metabolism (Y.L., Q.L., Y.B., A.L.G., R.J.G.), Diagnostic Imaging and Interventional Radiology (M.J.M.), Biostatistics and Bioinformatics (Z.J.T.), Cancer Epidemiology (J.J.H., M.B.S.), and Thoracic Oncology (M.B.S.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, MRC-CANCONT, Tampa, FL 33612
| | - Zhaoxiang Ye
- From the Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; and Tianjin's Clinical Research Center for Cancer, Tianjin, China (Y.L., H.W., Q.L., Z.Y.); and Departments of Cancer Imaging and Metabolism (Y.L., Q.L., Y.B., A.L.G., R.J.G.), Diagnostic Imaging and Interventional Radiology (M.J.M.), Biostatistics and Bioinformatics (Z.J.T.), Cancer Epidemiology (J.J.H., M.B.S.), and Thoracic Oncology (M.B.S.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, MRC-CANCONT, Tampa, FL 33612
| | - Robert J Gillies
- From the Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; and Tianjin's Clinical Research Center for Cancer, Tianjin, China (Y.L., H.W., Q.L., Z.Y.); and Departments of Cancer Imaging and Metabolism (Y.L., Q.L., Y.B., A.L.G., R.J.G.), Diagnostic Imaging and Interventional Radiology (M.J.M.), Biostatistics and Bioinformatics (Z.J.T.), Cancer Epidemiology (J.J.H., M.B.S.), and Thoracic Oncology (M.B.S.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, MRC-CANCONT, Tampa, FL 33612
| | - Matthew B Schabath
- From the Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; and Tianjin's Clinical Research Center for Cancer, Tianjin, China (Y.L., H.W., Q.L., Z.Y.); and Departments of Cancer Imaging and Metabolism (Y.L., Q.L., Y.B., A.L.G., R.J.G.), Diagnostic Imaging and Interventional Radiology (M.J.M.), Biostatistics and Bioinformatics (Z.J.T.), Cancer Epidemiology (J.J.H., M.B.S.), and Thoracic Oncology (M.B.S.), H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, MRC-CANCONT, Tampa, FL 33612
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Xiao H, Liu Y, Tan H, Liang P, Wang B, Su L, Wang S, Gao J. A pilot study using low-dose Spectral CT and ASIR (Adaptive Statistical Iterative Reconstruction) algorithm to diagnose solitary pulmonary nodules. BMC Med Imaging 2015; 15:54. [PMID: 26576676 PMCID: PMC4647278 DOI: 10.1186/s12880-015-0096-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 10/25/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lung cancer is the most common cancer which has the highest mortality rate. With the development of computed tomography (CT) techniques, the case detection rates of solitary pulmonary nodules (SPN) has constantly increased and the diagnosis accuracy of SPN has remained a hot topic in clinical and imaging diagnosis. The aim of this study was to evaluate the combination of low-dose spectral CT and ASIR (Adaptive Statistical Iterative Reconstruction) algorithm in the diagnosis of solitary pulmonary nodules (SPN). METHODS 62 patients with SPN (42 cases of benign SPN and 20 cases of malignant SPN, pathology confirmed) were scanned by spectral CT with a dual-phase contrast-enhanced method. The iodine and water concentration (IC and WC) of the lesion and the artery in the image that had the same density were measured by the GSI (Gemstone Spectral Imaging) software. The normalized iodine and water concentration (NIC and NWC) of the lesion and the normalized iodine and water concentration difference (ICD and WCD) between the arterial and venous phases (AP and VP) were also calculated. The spectral HU (Hounsfield Unit ) curve was divided into 3 sections based on the energy (40-70, 70-100 and 100-140 keV) and the slopes (λHU) in both phases were calculated. The ICAP, ICVP, WCAP and WCVP, NIC and NWC, and the λHU in benign and malignant SPN were compared by independent sample t-test. RESULTS The iodine related parameters (ICAP, ICVP, NICAP, NICVP, and the ICD) of malignant SPN were significantly higher than that of benign SPN (t = 3.310, 1.330, 2.388, 1.669 and 3.251, respectively, P <0.05). The 3 λHU values of venous phase in malignant SPN were higher than that of benign SPN (t = 3.803, 2.846 and 3.205, P <0.05). The difference of water related parameters (WCAP, WCVP, NWCAP, NWCVP and WCD) between malignant and benign SPN were not significant (t = 0.666, 0.257, 0.104, 0.550 and 0.585, P > 0.05). CONCLUSIONS The iodine related parameters and the slope of spectral curve are useful markers to distinguish the benign from the malignant lung diseases, and its application is extremely feasible in clinical applications.
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Affiliation(s)
- Huijuan Xiao
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| | - Yihe Liu
- The No.7 People's Hospital of Zhengzhou, 17 Jingnan 5th Road, Zhengzhou Economic and Technological Development Zone, Zhengzhou, Henan Province, 450000, China.
| | - Hongna Tan
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| | - Pan Liang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| | - Bo Wang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| | - Lei Su
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| | - Suya Wang
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
| | - Jianbo Gao
- The Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jianshe Road, Zhengzhou, Henan Province, 450052, China.
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Shi CZ, Zhao Q, Luo LP, He JX. Size of solitary pulmonary nodule was the risk factor of malignancy. J Thorac Dis 2014; 6:668-76. [PMID: 24976989 DOI: 10.3978/j.issn.2072-1439.2014.06.22] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 06/02/2014] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The purpose of this study was to analyze the role of the sizes of solitary pulmonary nodules (SPNs) in predicting their potential malignancies. METHODS A total of 379 patients with pathologically confirmed SPNs were enrolled in this study. They were divided into three groups based on the SPN sizes: ≤10, 11-20, and >20 mm. The computed tomography (CT) findings of these SPNs were analyzed in these three groups to identify the malignant and benign SPNs. The risk factors were analyzed using binary logistic regression analysis. RESULTS Of these 379 patients, 120 had benign SPNs and 259 had malignant SPNs. In the ≤10 mm SPN group, air cavity density was the risk factor for malignancy, with the sensitivity, specificity, and accuracy being 77.8%, 75.0%, and 76.3%. In the 11-20 mm SPN group, age, glitches and vascular aggregation were the risk factors for malignancy, with the sensitivity, specificity, and accuracy being 91.3%, 56.9%, and 81.5%. In the >20 mm SPN group, age, lobulation, and vascular aggregation were the risk factors for malignancy, with the sensitivity, specificity, and accuracy being 88.6%, 57.1%, and 79.1%. CONCLUSIONS According to CT findings of SPNs, age, glitches, lobulation, vascular aggregation, and air cavity density are the risk factors of malignancy, whereas calcification and satellite lesions are the protective factors. During the course of development from small to large nodules, air cavity density could be firstly detected in early stages, followed by glitches and vascular aggregation. Lobulation is associated with relatively large lesions.
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Affiliation(s)
- Chang-Zheng Shi
- 1 Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China ; 2 Department of Statistics, School of Public Health, Guangzhou Medical University, Guangzhou 510182, China ; 3 Department of Thoracic Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 4 Department of Surgery, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China ; 5 National Respiratory Disease Clinical Research Center, Guangzhou 510120, China
| | - Qian Zhao
- 1 Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China ; 2 Department of Statistics, School of Public Health, Guangzhou Medical University, Guangzhou 510182, China ; 3 Department of Thoracic Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 4 Department of Surgery, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China ; 5 National Respiratory Disease Clinical Research Center, Guangzhou 510120, China
| | - Liang-Ping Luo
- 1 Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China ; 2 Department of Statistics, School of Public Health, Guangzhou Medical University, Guangzhou 510182, China ; 3 Department of Thoracic Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 4 Department of Surgery, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China ; 5 National Respiratory Disease Clinical Research Center, Guangzhou 510120, China
| | - Jian-Xing He
- 1 Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China ; 2 Department of Statistics, School of Public Health, Guangzhou Medical University, Guangzhou 510182, China ; 3 Department of Thoracic Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 4 Department of Surgery, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China ; 5 National Respiratory Disease Clinical Research Center, Guangzhou 510120, China
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Shao W, Wang W, Yin W, Guo Z, Peng G, Chen Y, He J. Nonintubated thoracoscopic lobectomy plus lymph node dissection following segmentectomy for central type pulmonary masses. Chin J Cancer Res 2013; 25:124-7. [PMID: 23372351 DOI: 10.3978/j.issn.1000-9604.2013.01.04] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 01/05/2013] [Indexed: 11/14/2022] Open
Affiliation(s)
- Wenlong Shao
- Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China; ; Guangzhou Research Institute of Respiratory Disease, Guangzhou, China; ; China State Key Laboratory of Respiratory Disease, Guangzhou, China
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