Saito Hajime, Minamiya Yoshihiro, Kawai Hideki, Nakagawa Taku, Ito Manabu, Hosono Yukiko, Motoyama Satoru, Hashimoto Manabu, Ishiyama Koichi, Ogawa Jun-Ichi
Department of Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita City 010-8543, Japan.
Lung Cancer. 2007 Dec;58(3):348-54. doi: 10.1016/j.lungcan.2007.06.018. Epub 2007 Aug 6.
The presence of a small solitary pulmonary nodule (SSPN) is a common finding on chest computed tomography (CT); however, preoperative diagnosis of SSPN is often difficult. We measured the extent of ground-glass opacity (GGO) and our own original method of circumference difference (CD) as an additional approach in classifying SSPN revealed on CT, and evaluated the likelihood of malignancy.
In total, 214 single SSPN with diameter <15mm were studied. All SSPN were histologically examined with surgical resection; preoperative CT findings and pathological diagnosis were evaluated retrospectively. The extent of the ratio of GGO and CD was evaluated using NIH image, where CD is defined as the ratio of the nodule margin distance to the circumference of the predicted circle with an area equal to that of the nodule.
The thresholds for differentiating SSPN are 70% of GGO and 68% of the CD ratio. Differentiation of malignancy from benign tumor using our algorithm had sensitivity of 96.6%, specificity of 86.1%, and positive predictive value of 94.1%.
Combined with other malignant likelihood parameters such as extent of GGO, CD ratio is a useful additional factor for estimating the likelihood of malignancy of SSPN on CT.
孤立性肺小结节（SSPN）在胸部计算机断层扫描（CT）中较为常见；然而，术前诊断SSPN往往具有难度。我们测量了磨玻璃影（GGO）范围以及我们自己独创的周长差（CD）方法，作为对CT显示的SSPN进行分类的额外手段，并评估其恶性可能性。
共研究了214个直径<15mm的单个SSPN。所有SSPN均通过手术切除进行组织学检查；回顾性评估术前CT表现和病理诊断。使用美国国立卫生研究院（NIH）图像评估GGO比例和CD的范围，其中CD定义为结节边缘距离与面积等于结节的预测圆周长的比值。
区分SSPN的阈值为GGO占70%和CD比例占68%。使用我们的算法区分恶性肿瘤与良性肿瘤的敏感性为96.6%，特异性为86.1%，阳性预测值为94.1%。
结合其他恶性可能性参数，如GGO范围，CD比例是评估CT上SSPN恶性可能性的一个有用的附加因素。
