He Yifan, Xiong Ziqi, Zhang Jingyu, Xie Jiayue, Zhu Wen, Zhao Min, Li Zhiyong
Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Xigang District, Dalian, 116011, Zhongshan, China.
Department of Pathology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
J Cancer Res Clin Oncol. 2023 Sep;149(12):9937-9946. doi: 10.1007/s00432-023-04918-5. Epub 2023 May 30.
To investigate the differences of size and density measurements in assessing pure ground-glass nodules (pGGNs) growth, and compare the growth rates and growth proportions of the two methods during follow-up period.
Ninety patients with at least 3 consecutive thin-section chest CTs and confirmed 103 pGGNs on baseline CT were enrolled retrospectively. Using the two definitions of size and density to evaluate pGGNs growth with semi-automated segmentation. Then, the two methods were compared to assess differences in pGGNs growth.
For the size and density methods to assess nodule growth, 50.5% and 26.2% showed interval growth at the last CT (p < 0.001). Among the 19 nodules that grew in both size and density, the volume doubling time (VDT) of solid component (mean, 317.1; standard deviation, 224.8 days) was shorter than total VDT (median, 942.8; range, 400.1-2315.9 days) (p < 0.001). Of the 27 growth pGGNs assessed by the density method, the growth rates at years 1 and 2 were 25.9% and 63.0%, while the growth rates of 52 growing nodules assessed by size method were 11.5% and 48.1%, respectively. Twenty of 103 (19.4%) nodules were classified into category 4A lesions, and 7 (6.8%) were 4B lesions.
Compared to size measurements, observed density increases have a higher proportion of early growth and faster growth rates in growing nodules. Clinicians need to pay close attention to the nodules of new solid components and make timely decision management.
探讨在评估纯磨玻璃结节（pGGN）生长时大小和密度测量的差异，并比较随访期间两种方法的生长率和生长比例。
回顾性纳入90例至少有3次连续胸部薄层CT且基线CT确诊103个pGGN的患者。使用大小和密度的两种定义，通过半自动分割评估pGGN的生长。然后，比较两种方法以评估pGGN生长的差异。
对于评估结节生长的大小和密度方法，在最后一次CT检查时，分别有50.5%和26.2%显示有间期生长（p<0.001）。在大小和密度均生长的19个结节中，实性成分的体积倍增时间（平均317.1天；标准差224.8天）短于总体积倍增时间（中位数942.8天；范围400.1 - 2315.9天）（p<0.001）。在通过密度法评估的27个生长的pGGN中，第1年和第2年的生长率分别为25.9%和63.0%，而通过大小法评估的52个生长结节的生长率分别为11.5%和48.1%。103个结节中有20个（19.4%）被分类为4A类病变，7个（6.8%）为4B类病变。
与大小测量相比，观察到的密度增加在生长结节中的早期生长比例更高且生长速度更快。临床医生需要密切关注新出现实性成分的结节并及时做出管理决策。
