Diameter of the Solid Component in Subsolid Nodules on Low-Dose Unenhanced Chest Computed Tomography: Measurement Accuracy for the Prediction of Invasive Component in Lung Adenocarcinoma.
10.3348/kjr.2018.19.3.508
- Author:
Hyungwoo AHN
1
;
Kyung Hee LEE
;
Jihang KIM
;
Jeongjae KIM
;
Junghoon KIM
;
Kyung Won LEE
Author Information
1. Department of Radiology, Seoul National University Bundang Hospital, Seongnam 13620, Korea. kyung8404@gmail.com
- Publication Type:Original Article
- Keywords:
Lung adenocarcinoma;
Subsolid nodule;
Invasive component;
Measurement;
Low-dose CT
- MeSH:
Adenocarcinoma*;
Humans;
Lung*;
Thorax*;
Tomography, X-Ray Computed
- From:Korean Journal of Radiology
2018;19(3):508-515
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To determine if measurement of the diameter of the solid component in subsolid nodules (SSNs) on low-dose unenhanced chest computed tomography (CT) is as accurate as on standard-dose enhanced CT in prediction of pathological size of invasive component of lung adenocarcinoma. MATERIALS AND METHODS: From February 2012 to October 2015, 114 SSNs were identified in 105 patients that underwent low-dose unenhanced and standard-dose enhanced CT pre-operatively. Three radiologists independently measured the largest diameter of the solid component. Intraclass correlation coefficients (ICCs) were used to assess inter-reader agreement. We estimated measurement differences between the size of solid component and that of invasive component. We measured diagnostic accuracy of the prediction of invasive adenocarcinoma using a size criterion of a solid component ≥ 6 mm, and compared them using a generalized linear mixed model. RESULTS: Inter-reader agreement was excellent (ICC, 0.84.0.89). The mean ± standard deviation of absolute measurement differences between the solid component and invasive component was 4 ± 4 mm in low-dose unenhanced CT and 5 ± 4 mm in standard-dose enhanced CT. Diagnostic accuracy was 81.3% (95% confidence interval, 76.7.85.3%) in low-dose unenhanced CT and 76.6% (71.8.81.0%) in standard-dose enhanced CT, with no statistically significant difference (p = 0.130). CONCLUSION: Measurement of the diameter of the solid component of SSNs on low-dose unenhanced chest CT was as accurate as on standard-dose enhanced CT for predicting the invasive component. Thus, low-dose unenhanced CT may be used safely in the evaluation of patients with SSNs.
