Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.
Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea ; Cancer Research Institute, Seoul National University, Seoul, Korea.
PLoS One. 2014 Jan 8;9(1):e85167. doi: 10.1371/journal.pone.0085167. eCollection 2014.
Early discrimination between transient and persistent par-solid ground-glass nodules (PSNs) at CT is essential for patient management. The objective of our study was to retrospectively investigate the value of texture analysis in differentiating pulmonary transient and persistent PSNs in addition to clinical and CT features.
This retrospective study was performed with IRB approval and a waiver of the requirement for patients' informed consent. From January 2007 to October 2009, we identified 77 individuals (39 men and 38 women; mean age, 55 years) with 86 PSNs on thin-section chest CT. Thirty-nine PSNs in 31 individuals were transient and 47 PSNs in 46 patients were persistent. The clinical, CT, and texture features of PSNs were evaluated. To investigate the additional value of texture analysis in differentiating transient from persistent PSNs, logistic regression analysis and C-statistics were performed.
Between transient and persistent PSNs, there were significant differences in age, gender, smoking history, and eosinophil count among the clinical features. As for thin-section CT features, there were significant differences in lesion size, solid portion size, and lesion multiplicity. In terms of texture features, there were significant differences in mean attenuation, skewness of whole PSN, attenuation ratio of whole PSN to inner solid portion, and 5-, 10-, 25-, 50-percentile CT numbers of whole PSN. Multivariate analysis revealed eosinophilia, lesion size, lesion multiplicity, mean attenuation of whole PSN, skewness of whole PSN, and 5-percentile CT number were significant independent predictors of transient PSNs. (P<0.05) C-statistics revealed that texture analysis incorporating clinical and CT features (AUC, 92.9%) showed significantly higher differentiating performance of transient from persistent PSNs compared with the clinical and CT features alone (AUC, 79.0%). (P = 0.004).
Texture analysis of PSNs in addition to clinical and CT features analysis has the potential to improve the differentiation of transient from persistent PSNs.
在 CT 上早期区分一过性和持续性部分实性磨玻璃结节（PSN）对于患者的管理至关重要。我们的研究目的是回顾性研究纹理分析在除临床和 CT 特征外区分肺内一过性和持续性 PSN 的价值。
本回顾性研究获得了机构审查委员会的批准，并豁免了患者知情同意的要求。2007 年 1 月至 2009 年 10 月，我们在薄层胸部 CT 上共发现了 77 名患者（39 名男性和 38 名女性；平均年龄为 55 岁）的 86 个 PSN。31 名患者的 39 个 PSN 为一过性，46 名患者的 47 个 PSN 为持续性。评估 PSN 的临床、CT 和纹理特征。为了研究纹理分析在区分一过性和持续性 PSN 方面的额外价值，我们进行了逻辑回归分析和 C 统计分析。
在一过性和持续性 PSN 之间，临床特征中年龄、性别、吸烟史和嗜酸性粒细胞计数存在显著差异。在薄层 CT 特征方面，病变大小、实性部分大小和病变多发性存在显著差异。在纹理特征方面，整个 PSN 的平均衰减、整个 PSN 的偏度、整个 PSN 与内部实性部分的衰减比以及整个 PSN 的 5%、10%、25%和 50%的 CT 数存在显著差异。多变量分析显示，嗜酸性粒细胞增多、病变大小、病变多发性、整个 PSN 的平均衰减、整个 PSN 的偏度和整个 PSN 的 5%的 CT 数是一过性 PSN 的显著独立预测因子。（P<0.05）C 统计显示，与仅基于临床和 CT 特征的分析相比，纳入纹理分析的临床和 CT 特征（AUC，92.9%）显示出对一过性和持续性 PSN 更好的区分性能。（P=0.004）。
PSN 的纹理分析除了临床和 CT 特征分析外，还有助于提高对一过性和持续性 PSN 的区分。
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