Purpose. Methods and Materials

Transcription

1 Thin-section CT findings in peripheral lung cancer of 3 cm or smaller: are there any characteristic features for predicting tumor histology or do they depend only on tumor size? Poster No.: C-1893 Congress: ECR 2012 Type: Authors: Keywords: DOI: Scientific Exhibit C. Miyake, S. Takashima, T. Hakucho, Y. Takahashi, D. Morimoto, M. Uenishi; Osaka/JP Computer Applications-Detection, diagnosis, CT, Lung, Cavitation /ecr2012/C-1893 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 8

2 Purpose In case of lung cancer, ground-glass opacity (GGO) is reported to be characteristic to replacement-type of neoplasm, such as bronchioloalveolar carcinoma or adenocarcinoma with mixed subtypes. Therefore, we studied if there are any other thinsection CT (TSCT) findings characteristic to tumor histology or if they relate only to the tumor size. Methods and Materials This series included 106 solid type of peripheral lung cancer of 3 cm or smaller (56 of adenocarcinoma, 33 squamous cell carcinoma, 17 small cell carcinoma) in consecutive 105 patients (75 men and 30 women; mean age, 67 ± 9.5 (S.D.) years) who underwent surgical resection during May 2006 to December All patients had 16-slice MDCT with 1-mm collimation before surgery. Evaluated TSCT findings were 6 morphologic findings (presence or absence of lobulation, coarse spiculation, air bronchogram, cavity, pleural tag and pleural-based lesion) and 4 measurements (ratios of greatest to short transverse diameter, vertical to short transverse diameter, density of notch and coarse spiculation) (Fig. 1 on page 2). Density of notch is defined as the ratios of a total number of notch to greatest transverse diameter of nodules and density of coarse spiculation was defined as a total number of coarse spiculation to greatest transverse diameter of nodules. The numbers of notch and coarse spiculation were counted by referring to the semi-automatically constructed 3D images with computer aid (Fig. 2 on page 3). Differences in the prevalence and mean values among 3 tumor histology were assessed with Kruskal-Wallis test and Fisher's exact tests, and those among 3 groups of tumor size (<= 1cm, cm, 2.1-<= 3cm in greatest transverse diameter) were assessed with trend tests (Cochran-Armitage test and Jonckheere-Terpstra test). A p <0.05 was considered to be significant. Images for this section: Page 2 of 8

3 Fig. 1: TSCT findings. (a) lobulation; (b) coarse spiculation; (c) air bronchogram; (d) cavity; (e) pleural tag; (f) pleural based lesion. Page 3 of 8

4 Fig. 2: 3D volume rendering image of a nodule. A total of 2 coarse spiculations were identified on TSCT in reference to this 3D image. Page 4 of 8

5 Results As for the differences among tumor histologies, air bronchogram (p<0.01) was the only significant factor. The prevalence of air bronchogram was significantly greater in adenocarcinoma than in squamous cell carcinoma (p<0.01) or small cell carcinoma (p<0.01) (Table 1 on page 5). As the tumor size advanced, significant positive linear trends were seen in the prevalence of lobulation (p<0.01), coarse spiculation (p<0.01) and pleural tag (p<0.01), and the mean values of density of notch (p<0.01) and coarse spiculation (p<0.01), while significant negative linear trends were seen in ratios of vertical to short transverse diameter (p=0.02) (Table 2 on page 6). Images for this section: Table 1: TSCT findings and measurement results in correlation with tumor histology Page 5 of 8

6 Table 2: TSCT findings and measurement results in correlation with tumor size Page 6 of 8

7 Conclusion (1) Although air bronchogram was characteristic to adenocarcinoma, other TSCT findings were irrelevant to tumor histologies and related only to tumor size. (2) Prediction with TSCT of tumor histology for solid type of lung cancer is difficult, especially for small lung cancer, if it has no air bronchogram within it. References [1] Ikehara M, Saito H, Kondo T, et al. Comparison of thin-section CT and pathological findings in small solid-density type pulmonary adenocarcinoma: Prognostic factors from CT findings. Eur J Radiol Oct 19. [2] Saito H, Kameda Y, Masui K, et al. Correlations between thin-section CT findings, histopathological and clinical findings of small pulmonary adenocarcinomas. Lung Cancer Feb;71(2): [3] Zwirewich CV, Vedal S, Miller RR, Müller NL. Solitary pulmonary nodule: highresolution CT and radiologic-pathologic correlation. Radiology May;179(2): [4] Shah RM, Edmonds P, Wechsler RJ, Salazar AM. Adjacent parenchymal abnormalities in peripheral bronchogenic carcinoma: correlation of thin-section CT with histology. J Thorac Imaging Apr;19(2): [5] Kim HY, Shim YM, Lee KS, et al. Persistent pulmonary nodular ground-glass opacity at thin-section CT: histopathologic comparisons. Radiology Oct;245(1): [6] Nakazono T, Sakao Y, Yamaguchi K, et al. Subtypes of peripheral adenocarcinoma of the lung: differentiation by thin-section CT. Eur Radiol Aug;15(8): Personal Information Chie Miyake Page 7 of 8

8 Osaka University Graduate School of Medicine, Division of Allied Health Sciences, Department of Diagnostic Radiological Imaging, Osaka, Japan ; Page 8 of 8