Three Dimensional Volumetric Analysis of Solid Pulmonary Nodules on Chest CT：Cancer Risk Assessment
10.3779/j.issn.1009-3419.2016.05.05
- VernacularTitle:CT三维容积分析在实性肺结节恶性风险度评估中的价值
- Author:
LI MENGQI
1
;
HAN RONGCHENG
;
SONG WENJING
;
WANG XINYUE
;
GUO FANGFANG
;
SU DATONG
;
YU TIELIAN
;
WANG YING
Author Information
1. 天津医科大学总医院医学影像科
- Keywords:
Pulmonary nodules;
Computed tomography;
Volume;
hTree-dimensional volumetric analysis;
Can-cer risk assessment
- From:
Chinese Journal of Lung Cancer
2016;19(5):279-285
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective hTe management of pulmonary nodules relies on cancer risk assessment, in which the only widely accepted criterion is diameter. hTe development of volumetric computed tomography (CT) and three-dimensional (3D) sotfware enhances the clarity in displaying the nodules’ characteristics. hTis study evaluated the values of the nodules’ volume and 3D morphological characteristics (edge, shape and location) in cancer risk assessment.Methods hTe CT data of 200 pulmonary nodules were retrospectively evaluated using 3D volumetric sotfware. hTe malignancy or benignity of all the nodules was conifrmed by pathology, histology or follow up (>2 years).Logistic regression analysis was performed to calculate the odds ratios (ORs) of the 3D margin (smooth, lobulated or spiculated/irregular), shape (spherical or non-spherical), location (purely intraparenchymal, juxtavascular or pleural-attached), and nodule volume in cancer risk assessment for total and sub-centimeter nodules. hTe receiver operating characteristic (ROC) curve was employed to determine the opti-mal threshold for the nodule volume.Results Out of 200 pulmonary nodules, 78 were malignant, whereas 122 were benign. hTeLogistic regression analysis showed that the volume (OR=3.3;P<0.001) and the 3D margin (OR=13.4, 9.8; bothP=0.001) were independent predictive factors of malignancy, whereas the location and 3D shape exhibited no total predictive value (P>0.05). ROC analysis showed that the optimal threshold for malignancy was 666 mm3. For sub-centimeter nodules, the 3D margin was the only valuable predictive factor of malignancy (OR=60.5, 75.0;P=0.003, 0.007).Conclusion hTe volume and 3D margin are important factors considered to assess the cancer risk of pulmonary nodules. Volumes larger than 666 mm3 can be determined as high risk for pulmonary nodules; by contrast, nodules with lobulated, spiculated, or irregular margin present a high malignancy probability.
