Three-dimensional substructure measurements for the differential diagnosis of ground glass nodules

Abstract Background The presence of pulmonary vessels inside ground-glass nodules (GGNs) of different nature is a very common occurrence. This study aimed to reveal the significance of pulmonary vessels displayed in GGNs in their diagnosis and differential diagnosis. Results A total of 149 malignant and 130 benign GGNs confirmed by postoperative pathological examination were retrospectively enrolled in this study. There were significant differences in size, shape, nodule-lung interface, pleural traction, lobulation, and spiculation (each p < 0.05) between benign and malignant GGNs. Compared with benign GGNs, intra-nodular vessels were more common in malignant GGNs (67.79% vs. 54.62%, p = 0.024), while the vascular categories were similar (p = 0.663). After adjusting the nodule size and the distance between the nodule center and adjacent pleura [radius–distance ratio, RDR], the occurrences of internal vessels between them were similar. The number of intra-nodular vessels was positively correlated with nodular diameter and RDR. Vascular changes were more common in malignant than benign GGNs (52.48% vs. 18.31%, p < 0.0001), which mainly manifested as distortion and/or dilation of pulmonary veins (61.19%). The occurrence rate, number, and changes of internal vessels had no significant differences among all the pre-invasive and invasive lesions (each p > 0.05). Conclusions The incidence of internal vessels in GGNs is mainly related to their size and the distance between nodule and pleura rather than the pathological nature. However, GGNs with dilated or distorted internal vessels, especially pulmonary veins, have a higher possibility of malignancy.

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Preoperative Prediction of Ki-67 Labeling Index By Three-dimensional CT Image Parameters for Differential Diagnosis Of Ground-Glass Opacity (GGO)

PLoS ONE ◽

10.1371/journal.pone.0129206 ◽

2015 ◽

Vol 10 (6) ◽

pp. e0129206 ◽

Cited By ~ 2

Author(s):

Mingzheng Peng ◽

Fei Peng ◽

Chengzhong Zhang ◽

Qingguo Wang ◽

Zhao Li ◽

...

Keyword(s):

Differential Diagnosis ◽

Three Dimensional ◽

Ground Glass Opacity ◽

Labeling Index ◽

Ground Glass ◽

Ct Image ◽

Ki 67 ◽

Preoperative Prediction

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Post-Anesthesia Hookwire Localization of Pulmonary Ground Glass Nodules Guided by Computed-Tomography Three-Dimensional Reconstruction: A Feasibility Study

10.21203/rs.3.rs-332644/v1 ◽

2021 ◽

Author(s):

Chong Wang ◽

Yang Liu ◽

Bo Xiao ◽

Shuku Liu

Keyword(s):

Computed Tomography ◽

Three Dimensional ◽

Effective Rate ◽

Needle Insertion ◽

Ground Glass ◽

Pain Patient ◽

Three Dimensional Reconstruction ◽

Ct Guided ◽

Dimensional Reconstruction ◽

Ground Glass Nodules

Abstract Background: Computed-tomography(CT) guided hookwire localization has disadvantages, such as pain, patient transport risk and increased radiation exposure. In order to overcome the above shortcomings, our method is post-anesthesia hookwire localization guided by preoperative CT three-dimensional reconstruction. The effectiveness and safety of this method will be studied.Methods: A total of 36 patients(36 nodules) with ground glass nodules were consecutively included in this study. Three dimensional reconstruction of chest CT was performed to simulate the puncture path. The puncture point, the depth and angle of needle insertion were recorded. After anesthesia, the puncture point was marked on the patient's body surface. Hookwire was placed according to the previous planned puncture direction and depth. The effectiveness and complications of the localization were evaluated during the operation.Results: Hookwire dislocation was found in 1 patient in operation. The other 35 nodules were successfully positioned. The median distance between hookwire and lesion was 14mm(3-25mm). The effective rate was 97.2%(35/36). Only one patient found a small amount of blood in the chest. There was no pulmonary hematoma, blood pressure or oxygen decreasing in all patients. The complication rate was 2.8% (1/36) and the severe complication was 0. The median time for localization was 3 minutes. Conclusion: Post-anesthesia hookwire localization guided by preoperative three-dimensional reconstruction is a simple, safe and effective localization method, which is suitable for appropriate nodules, and is an important supplement to CT guided localization.Trial registration: ChiCTR1900023853. Registered in Chinese Clinical Trail Registry on 14 June 2019, http://www.chictr.org.cn/showprojen.aspx?proj=40060

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CT Characteristics for Predicting Invasiveness in Pulmonary Pure Ground-Glass Nodules

American Journal of Roentgenology ◽

10.2214/ajr.19.22381 ◽

2020 ◽

Vol 215 (2) ◽

pp. 351-358 ◽

Cited By ~ 1

Author(s):

Zhi-gang Chu ◽

Wang-jia Li ◽

Bin-jie Fu ◽

Fa-jin Lv

Keyword(s):

Ground Glass ◽

Ground Glass Nodules

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Use of CT radiomics to differentiate minimally invasive adenocarcinomas and invasive adenocarcinomas presenting as pure ground-glass nodules larger than 10 mm

European Journal of Radiology ◽

10.1016/j.ejrad.2021.109772 ◽

2021 ◽

pp. 109772

Author(s):

Ziqi Xiong ◽

Yining Jiang ◽

Siyu Che ◽

Wenjing Zhao ◽

Yan Guo ◽

...

Keyword(s):

Minimally Invasive ◽

Ground Glass ◽

Ground Glass Nodules

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Diffuse Cystic Metastases in the Lung after Nivolumab Treatment in a Patient with Non-Small Cell Lung Cancer: A Case Report

Case Reports in Oncology ◽

10.1159/000513426 ◽

2021 ◽

pp. 34-38

Author(s):

Satoshi Muto ◽

Yuki Ozaki ◽

Takuya Inoue ◽

Naoyuki Okabe ◽

Yuki Matsumura ◽

...

Keyword(s):

Lung Adenocarcinoma ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Lung Metastases ◽

Sialyl Lewis X ◽

Ground Glass ◽

Cystic Lesions ◽

Positron Emission ◽

Ground Glass Nodules

Although diffuse cysts in the lung can be found in many diseases, they are uncommon in metastatic lung adenocarcinoma. They are even more unusual after the administration of immune checkpoint inhibitors. A case of lung adenocarcinoma that developed diffuse cysts in the lungs during treatment with nivolumab is reported. The patient was a 60-year-old woman with postoperative recurrent lung adenocarcinoma in mediastinal lymph nodes and pleural dissemination. After first-line treatment with cisplatin, pemetrexed, and bevacizumab, computed tomography (CT) showed disease progression. Treatment was then switched to nivolumab. After 5 courses of nivolumab, CT showed multiple ground-glass nodules in her lungs. After 4 more courses of nivolumab, the ground-glass nodules increased in size, and cystic air spaces appeared in their centers. The patient did not have any symptoms. Laboratory tests showed no evidence of infection or nivolumab-induced pneumonitis. Sialyl Lewis X-i antigen increased, and positron emission tomography showed abnormal uptake of 18F-fluorodeoxyglucose in these lesions. Considering this evidence, the cystic lesions were diagnosed as multiple lung metastases. Various differential diagnoses should be considered when diffuse cystic lesions are found in the lungs after the administration of immune checkpoint inhibitors.

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