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. 2018 Mar;33(2):340-346.
doi: 10.3904/kjim.2016.134. Epub 2016 Feb 15.

Computed tomography morphologic features of pulmonary adenocarcinoma with brain/bone metastasis

Ki-Eun Hwang  1 , Su-Jin Oh  1 , Chul Park  1 , Se-Jeong Jeon  2 , Jeong-Mi Lee  3 , Byong-Ki Cha  4 , Kwon-Ha Yoon  2 , Eun-Taik Jeong  1 , Hak-Ryul Kim  1
Affiliations

Computed tomography morphologic features of pulmonary adenocarcinoma with brain/bone metastasis

Ki-Eun Hwang et al. Korean J Intern Med. 2018 Mar.

Abstract

Background/aims: Brain and bone metastases are common in patients with lung cancer. The development of metastasis is associated with poor survival in lung cancer patients. Although tumor morphologic features on radiographs are routinely assessed for differentiation between benign and malignant lung nodules, they are not used to predict metastasis. We assessed morphologic features of pulmonary adenocarcinomas with brain/bone metastasis on computed tomography (CT) to identify related factors for metastasis.

Methods: We performed a retrospective analysis of initial chest CT findings (size, type of contour, percentage of necrosis, enhancement, presence or absence of calcification, and air cavity) from 2009 to 2010 of patients with brain or bone metastasis and compared the findings with those of patients without metastases.

Results: In total, 128 patients were included (78 men, 52 women; mean age 69 years; range, 36 to 87). Nineteen patients had brain metastases and 32 had bone metastases. Morphologic features associated with brain metastasis included size ≥ 50 mm (odds ratio [OR], 3.37; 95% confidence interval [CI], 1.24 to 9.17; p = 0.013), necrosis ≥ 30% (OR, 4.51; 95% CI, 1.62 to 12.55; p =0.002), and presence of calcification (OR, 3.97; 95% CI, 1.16 to 13.55; p = 0.035). Morphologic features associated with bone metastasis included necrosis ≥ 30% (OR, 4.639; 95% CI, 1.98 to 10.82; p < 0.001) and T 3 to 4 stage (OR, 2.53; 95% CI, 1.07 to 6.00; p = 0.031).

Conclusions: We found that necrosis ≥ 30% was associated with pulmonary adenocarcinoma with brain and bone metastasis at initial chest CT morphologic feature. To validate these results, further research should be conducted.

Keywords: Adenocarcinoma; Computed tomography; Morphologic features; Necrosis; Neoplasm metastasis.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Illustration of computed tomography features of pulmonary adenocarcinoma investigated in this study. (A) Necrosis (–), (B) necrosis (+). Arrow indicates features of interest in each image.
See this image and copyright information in PMC

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