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. 2012 Jul;60(7):425-30.
doi: 10.1007/s11748-012-0066-7. Epub 2012 Jun 1.

One-dimensional mean computed tomography value evaluation of ground-glass opacity on high-resolution images

Akihiko Kitami  1 , Yoshito Kamio, Shoko Hayashi, Kosuke Suzuki, Shugo Uematsu, Ryozo Gen, Takashi Suzuki, Mitsutaka Kadokura
Affiliations

One-dimensional mean computed tomography value evaluation of ground-glass opacity on high-resolution images

Akihiko Kitami et al. Gen Thorac Cardiovasc Surg. 2012 Jul.

Abstract

Objective: Differentiation of atypical adenomatous hyperplasia (AAH), bronchioloalveolar carcinoma (BAC), and invasive carcinoma on computed tomography (CT) is useful for determining "follow-up or resection" strategies for lesions displaying ground-glass opacity (GGO). The purpose of this study is to evaluate one-dimensional quantitative CT values of GGO on high-resolution CT (HRCT) images using computer-aided diagnosis.

Methods: Between April 2001 and March 2010, a total of 44 nodules in 42 patients with pure or mixed GGOs ≤2 cm were retrospectively evaluated. Maximum diameter and one-dimensional mean CT (m-CT) value of the diameter were measured using a computer graphics support system (HOPE/DrABLE-EX, Fujitsu, Tokyo, Japan) that displays a CT density profile across the tumor.

Results: m-CT values were -682 ± 64 HU (range) for AAH lesions, -544 ± 179 (range) for Type A lesions, -496 ± 147 (range) for Type B lesions, and -371 ± 142 (range) for invasive lesions. AAH lesions had a significantly lower m-CT value than Type B lesions. AAH, Type A, and Type B lesions had significantly lower m-CT values than invasive lesions (p < 0.05). All seven GGO lesions with a maximum diameter ≤1 cm and m-CT value ≤-600 HU were pre-invasive lesions, while 16 of 22 (73 %) cases with maximum diameter >1 cm and m-CT value >-600 HU were invasive lesions.

Conclusion: Observation may be indicated for GGO lesions with a maximum diameter ≤1 cm and m-CT value ≤-600 HU.

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Figures

Fig. 1
Fig. 1
The CT image with a profile of the density across the tumor. The profile of pure GGO revealed an almost flat curve, and the m-CT value was calculated to be −760 HU (a). The profile of mixed GGO revealed that the CT value of the solid portion was higher than the GGO portion, and the m-CT value was calculated to be −440 HU (b)
Fig. 2
Fig. 2
The m-CT values were −682 ± 64 HU (range) for AAH lesions, −544 ± 179 (range) for Type A lesions, −496 ± 147 (range) for Type B lesions, and −371 ± 142 (range) for invasive lesions. AAH lesions had a significantly lower m-CT value than Type B lesions. AAH, Type A, and Type B lesions had a significantly lower m-CT values than invasive lesions (p < 0.05). No significant differences in m-CT values were observed between AAH and Type A lesions or between Type A and Type B lesions. The m-CT value of AAH lesions were all ≤−600 HU, while most of the m-CT values of invasive lesions were >−600 HU
Fig. 3
Fig. 3
a, b Relationship between m-CT value and maximum diameter of all GGO lesions. All seven GGO lesions with a maximum diameter ≤1 cm in the maximum diameter and m-CT value ≤−600 HU were pre-invasive lesions, while 16 of 22 (73 %) with a maximum diameter >1 cm and m-CT value >−600 HU in m-CT were invasive lesions
Fig. 4
Fig. 4
a, b Relationship between m-CT value and maximum diameter of pure and mixed type GGO lesions. GGO lesions ≤1 cm in maximum diameter and ≤−600 HU in m-CT value are all pure type. Although, GGO lesions of both categories with a maximum diameter >1 cm and m-CT value >−600 HU are highly diagnosed as invasive lesions, specificity of pure GGO were significantly better than that of mixed GGO
See this image and copyright information in PMC

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