Medical Imaging Department, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Pathology Department, First Affiliated Hospital of Kunming Medical University, Kunming, China.
J Cancer Res Clin Oncol. 2023 Aug;149(9):5901-5906. doi: 10.1007/s00432-022-04543-8. Epub 2023 Jan 3.
Mixed ground-glass lung nodules are a high-risk factor for lung adenocarcinoma. This study aimed to analyze the value of SDCT electron density imaging in the detection of mixed ground-glass lung nodules (GGNs).
150 patients with GGNs confirmed by chest SDCT and surgical pathology were retrospectively analyzed. GGNs were screened by two senior radiologists by the double-blind method based on conventional CT and SDCT electron density images. Average CT values and electron density (ED) values of GGNs were measured for all, solid and ground-glass.
Thirty pGGN cases determined by conventional CT were found to be mGGN on electron density images, including 23 in the invasive adenocarcinoma group (detection rate of 35.38%), which was significantly higher than that of the PGL group (14.89%, P < 0.05). In electron density images, average CT values and ED values in the PGL and invasive adenocarcinoma groups with pGGNs were no difference. The average CT value and ED value were significantly higher in the mGGN invasive adenocarcinoma group compared with the PGL group (P < 0.05). Meanwhile, ROC curve analysis of average CT value and ED value revealed AUC values for mGGN infiltration of 0.759 and 0.752.
SDCT can improve GGN visualization and increase the detection rate of mGGN compared with conventional CT. Attention should be paid to invasive adenocarcinoma for lung GGNs detected as mGGNs with high average CT value or ED value.
混合磨玻璃结节是肺腺癌的高危因素。本研究旨在分析 SDCT 电子密度成像在检测混合磨玻璃结节（GGN）中的价值。
回顾性分析经胸部 SDCT 和手术病理证实的 150 例 GGN 患者。两名资深放射科医生采用双盲法，基于常规 CT 和 SDCT 电子密度图像筛选 GGN。测量所有实性和磨玻璃成分的平均 CT 值和电子密度（ED）值。
30 例常规 CT 确定的 pGGN 在电子密度图像上被发现为 mGGN，其中 23 例位于浸润性腺癌组（检出率为 35.38%），明显高于 PGL 组（14.89%，P<0.05）。在电子密度图像中，pGGN 的 PGL 组和浸润性腺癌组的平均 CT 值和 ED 值无差异。mGGN 浸润性腺癌组的平均 CT 值和 ED 值明显高于 PGL 组（P<0.05）。同时，平均 CT 值和 ED 值的 ROC 曲线分析显示 mGGN 浸润的 AUC 值分别为 0.759 和 0.752。
与常规 CT 相比，SDCT 可以提高 GGN 的可视化程度，增加 mGGN 的检出率。对于检测为 mGGN 且平均 CT 值或 ED 值较高的肺 GGN，应注意浸润性腺癌。
