From the Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehangno, Jongno-gu, Seoul 110-744, Korea (Y.S.S., C.M.P., S.J.P., S.M.L., J.M.G.); Cancer Research Institute, Seoul National University, Seoul, Korea (C.M.P., S.J.P., J.M.G.); and Department of Pathology, Seoul National University College of Medicine, Seoul, Korea (Y.K.J.).
Radiology. 2014 Oct;273(1):276-84. doi: 10.1148/radiol.14132324. Epub 2014 Jun 14.
To evaluate volume doubling time (VDT) and mass doubling time (MDT) of persistent pulmonary subsolid nodules (SSNs) followed-up with low-dose (LD) computed tomography (CT) in patients without a history of malignancy.
This retrospective institutional review board-approved study, with waiver of patient informed consent, included 97 SSNs in 97 patients (45 men, 52 women; median age, 58 years; range, 37-87 years) in whom at least two LD CT scans were obtained, with 3-month or longer follow-up interval and median follow-up of 633 days. SSNs were categorized into pure ground-glass nodules (GGNs) (group A), part-solid GGNs with solid components of 5 mm or smaller (group B), and part-solid GGNs with solid components larger than 5 mm (group C). Three-dimensional manual segmentation for all SSNs was performed on initial and latest follow-up LD CT scans; subsequently, VDTs and MDTs were calculated and were compared among groups by using Kruskal-Wallis test, followed by the Dunn procedure with Bonferroni correction for volume-growing SSNs and mass-growing SSNs.
Volume growth was thus: 12 of 63 SSNs (19%), group A; nine of 23 SSNs (39%), group B; and eight of 11 SSNs (73%), group C. Median VDT was thus: 1832.3 days (range, 1230.7-4537.3 days), group A; 1228.5 days (range, 934.7-4617.7 days), group B; and 759.0 days (range, 376.4-941.5 days), group C. Mass growth was thus: 17 of 63 SSNs (27%), group A; 11 of 23 SSNs (48%), group B; and nine of 11 SSNs (82%), group C. Median MDT was 1556.1 days (range, 642.5-3564.5 days) for group A, 1199.9 days (range, 838.6-2578.7 days) for group B, and 627.7 days (range, 340.0-921.2 days) for group C. Median VDTs and MDTs of groups A and B were significantly longer than those of group C (P < .01).
Pure GGNs and part-solid GGNs with solid components of 5 mm or smaller show significantly longer VDTs and MDTs than do part-solid GGNs with solid components larger than 5 mm. Online supplemental material is available for this article.
评估无恶性肿瘤病史患者行低剂量 CT 随访的持续性肺部亚实性结节(SSN)的体积倍增时间(VDT)和质量倍增时间(MDT)。
本回顾性研究经机构审查委员会批准,患者无需知情同意,并豁免该程序。共纳入 97 例患者的 97 个 SSN(45 名男性,52 名女性;中位年龄为 58 岁;范围:37-87 岁),这些患者至少进行了两次 LD CT 扫描,随访时间间隔至少为 3 个月,中位随访时间为 633 天。SSNs 分为纯磨玻璃结节(GGN)(A 组)、部分实性 GGN 且实性成分≤5mm(B 组)和部分实性 GGN 且实性成分>5mm(C 组)。在初始和最新的 LD CT 扫描上对所有 SSNs 进行三维手动分割;随后,计算 VDT 和 MDT,并使用 Kruskal-Wallis 检验比较各组间的 VDT 和 MDT,体积增长的 SSNs 和质量增长的 SSNs 采用 Dunn 程序,Bonferroni 校正。
体积生长情况为:63 个 SSN 中有 12 个(19%),A 组;23 个 SSN 中有 9 个(39%),B 组;11 个 SSN 中有 8 个(73%),C 组。VDT 中位数分别为:A 组为 1832.3 天(范围:1230.7-4537.3 天);B 组为 1228.5 天(范围:934.7-4617.7 天);C 组为 759.0 天(范围:376.4-941.5 天)。质量生长情况为:63 个 SSN 中有 17 个(27%),A 组;23 个 SSN 中有 11 个(48%),B 组;11 个 SSN 中有 9 个(82%),C 组。A 组 MDT 中位数为 1556.1 天(范围:642.5-3564.5 天),B 组为 1199.9 天(范围:838.6-2578.7 天),C 组为 627.7 天(范围:340.0-921.2 天)。A 组和 B 组的 VDT 和 MDT 中位数明显长于 C 组(P<.01)。
纯 GGN 和部分实性 GGN 且实性成分≤5mm 的 VDT 和 MDT 明显长于部分实性 GGN 且实性成分>5mm。本文提供了在线补充材料。