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PLoS One. 2018 Oct 18;13(10):e0205490. doi: 10.1371/journal.pone.0205490. eCollection 2018.

High versus low attenuation thresholds to determine the solid component of ground-glass opacity nodules.

Author information

1
Department of Radiology and the Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University college of Medicine, Seoul, Republic of Korea.
2
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University college of Medicine, Seoul, Republic of Korea.
3
Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
4
Division of Pulmonology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Abstract

OBJECTIVES:

To evaluate and compare the diagnostic accuracy of high versus low attenuation thresholds for determining the solid component of ground-glass opacity nodules (GGNs) for the differential diagnosis of adenocarcinoma in situ (AIS) from minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IA).

METHODS:

Eighty-six pathologically confirmed GGNs < 3 cm observed in 86 patients (27 male, 59 female; mean age, 59.3 ± 11.0 years) between January 2013 and December 2015 were retrospectively included. The solid component of each GGN was defined using two different attenuation thresholds: high (-160 Hounsfield units [HU]) and low (-400 HU). According to the presence or absence of solid portions, each GGN was categorized as a pure GGN or part-solid GGN. Solid components were regarded as indicators of invasive foci, suggesting MIA or IA.

RESULTS:

Among the 86 GGNs, there were 57 cases of IA, 19 of MIA, and 10 of AIS. Using the high attenuation threshold, 44 were categorized as pure GGNs and 42 as part-solid GGNs. Using the low attenuation threshold, 13 were categorized as pure GGNs and 73 as part-solid GGNs. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for the invasive focus were 55.2%, 100%, 100%, 22.7%, and 60.4%, respectively, for the high attenuation threshold, and 93.4%, 80%, 97.2%, 61.5%, and 91.8%, respectively, for the low attenuation threshold.

CONCLUSION:

The low attenuation threshold was better than the conventional high attenuation threshold for determining the solid components of GGNs, which indicate invasive foci.

PMID:
30335856
PMCID:
PMC6193644
DOI:
10.1371/journal.pone.0205490
[Indexed for MEDLINE]
Free PMC Article

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