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. 2020 Jul 6;15(1):162.
doi: 10.1186/s13019-020-01159-2.

The feasibility of non-contrast enhanced plus contrast-enhanced computed tomography in discriminating invasive pure ground-glass opacity from pre-invasive pure ground-glass opacity

Shanshan Li  1 , Jinming Yu  2 , Xue Meng  1 , Lingfei Liu  1 , Liang Xu  1 , Liheng Liu  1 , Haiying Yu  1 , Yongsheng Gao  1 , Zhen Zhang  3
Affiliations

The feasibility of non-contrast enhanced plus contrast-enhanced computed tomography in discriminating invasive pure ground-glass opacity from pre-invasive pure ground-glass opacity

Shanshan Li et al. J Cardiothorac Surg. .

Abstract

Background: Invasive pure ground-glass opacity and pre-invasive pure ground-glass opacity have different 5-year overall survival rate and risk of lymph node metastasis and the extent of resection. It is difficult to discriminate these nodules since they share similar CT features and may occur concurrently. The objectives of this study were to investigate the feasibility of non-contrast enhanced plus contrast-enhanced computed tomography in discriminating invasive pure ground-glass opacity from pre-invasive pure ground-glass opacity.

Methods: We retrospectively examined 90 patients with pure ground-glass opacity who underwent non-contrast enhanced and contrast-enhanced CT according to a simplified protocol (one non-contrast enhanced measurement and two contrast-enhanced measurements at 30 s and 60 s after contrast injection) from 2015 to 2019. All imaging examinations were analyzed using three-dimensional computer-aided volume. Two independent samples t tests, one-way analysis of variance, chi-square test and logistic regression were used for analysis. A receiver operating characteristic curve was used to determine the optimal cut-off value of mean CT attenuation for differentiation of groups and to obtain diagnostic value.

Results: (1) The CT values of one non-contrast-enhanced, two contrast-enhanced and volume measurements between two groups had statistically significant differences (P < 0.001). (2) At the 30-s scan, there were more nodules in the pre-invasive group with no enhancement than in the pre-invasive group, which was statistically significant. (3) The CT value of 60-s scan was independent predictor of invasive adenocarcinoma (P = 0.019).

Conclusions: Non-contrast enhanced plus two contrast-enhanced CT based on volume measurements can differentiate invasive pGGO from pre-invasive pGGO.

Keywords: Adenocarcinoma; Ground-grass opacity (GGO); Mean computer tomography value; Volumetric CT.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
volume-rendering technique CT image and Pathological sections (hematoxylin-eosin staining,original magnification× 40) (a, b) CT image of pure ground-glass nodules opacity in the right medium lobe of a 67-year-female. Image show that vessels passed through the GGO were eliminated manually. Pathological results confirmed the diagnosis of adenocarcinoma in situ (AIS). c, d CT image of pure ground-glass nodules opacity in the right medium lobe of a 52-year-female. Pathological results confirmed the diagnosis of minimally invasive adenocarcinoma (MIA). e, f CT image of pure ground-glass nodules opacity in the left upper lobe of a 63-year-male. Pathological results confirmed the diagnosis of invasive adenocarcinoma (IAC)
Fig. 2
Fig. 2
ROC curves of three scans and volumes for indicating invasive adenocarcinoma
See this image and copyright information in PMC

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