Consolidation volume and integration of computed tomography values on three-dimensional computed tomography may predict pathological invasiveness in early lung adenocarcinoma

• Published in: Surgery today (Tokyo, Japan) Japan), 2021-08, Vol.51 (8), p.1320-1327
• Main Authors: Saeki, Yusuke, Kitazawa, Shinsuke, Yanagihara, Takahiro, Kobayashi, Naohiro, Kikuchi, Shinji, Goto, Yukinobu, Ichimura, Hideo, Sato, Yukio
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Article; Surgery; Surgical Oncology
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-021-02231-7

Purpose To investigate the relationship between three-dimensional computed tomography (3D-CT) findings and pathological invasiveness in lung adenocarcinoma. Methods We retrospectively evaluated 95 patients who underwent surgical resection of lung adenocarcinoma of ≤ 20 mm. The diameters, volumes, and CT values of tumor consolidation were analyzed. We defined the modified CT value by setting air as 0 and water as 1000 and assumed a correlation with pathological invasiveness. Pre-invasive lesions and minimally invasive adenocarcinomas were classified as non-invasive adenocarcinoma. We compared the clinico-radiological features with pathological invasiveness. Receiver operator characteristic (ROC) curves and recurrence-free survival curves were constructed. Results Twenty-six non-invasive adenocarcinomas and 69 invasive adenocarcinomas were evaluated. The multivariate analysis revealed that the consolidation volume and the integration of modified CT values were the most important predictors of pathological invasion. The area under the ROC curve and the cut-off values of the consolidation volume were 0.868 and 75 mm 3 , respectively. The area under the ROC curve and the cut-off values of the integration of modified CT values were 0.871 and 80,000, respectively. There was no recurrence in cases with values below the cut-off across all parameters. Conclusion The consolidation volume and integration of modified CT values were shown to be highly predictive of pathological invasiveness.