Oncologic outcomes of segmentectomy versus lobectomy for radiologically aggressive small-sized lung cancer.

8525 Background: Despite increasing evidence of favorable outcomes after segmentectomy for indolent lung cancer, such as ground glass opacity-dominant tumors, the adaptation of segmentectomy for radiologically aggressive lung cancer remains controversial. We attempted to elucidate oncologic outcomes after segmentectomy for radiologically aggressive lung cancer. Methods: Data from a multicenter database of 1353 patients with completely resected clinical Stage IA1–IA2 lung cancer at three institutions were retrospectively analyzed to identify radiologically aggressive lung cancer and compare outcomes of segmentectomy versus lobectomy in patients with radiologically aggressive lung cancer using propensity score matching. Results: Multivariable analysis showed that consolidation to maximum tumor (C/T) ratio on preoperative high-resolution computed tomography ( P= 0.037) and maximum standardized uptake value (SUVmax) on 18-fluorodeoxyglucose positron emission tomography/computed tomography ( P= 0.029) were independent predictors of recurrence-free survival (RFS). The criteria for radiologically aggressive lung cancer were determined as C/T ratio ≥ 0.8 or SUVmax ≥ 2.5, for which 522 patients were identified. RFS and overall survival (OS) were significantly worse in patients with aggressive lung cancer (5-year RFS, 83.3%; 5-year OS, 89.4%) than in those without the same (5-year RFS, 97.0%; P< 0.0001; 5-year OS, 97.3%; P< 0.0001). Among patients with aggressive lung cancer, no significant difference in RFS and OS was found between those undergoing lobectomy (n = 392) (5-year RFS, 81.3%; 5-year OS, 88.3%) and segmentectomy (n = 130) (5-year RFS, 90.0%; P= 0.33; 5-year OS, 92.3%; P= 0.76). Among the 111 pairs propensity matched for age, sex, smoking history, solid tumor size, C/T ratio, SUVmax, tumor location, clinical stage, and histology, similar RFS and OS were found between those undergoing lobectomy (5-year RFS, 83.3%; 5-year OS, 88.3%) and segmentectomy (5-year RFS, 90.9%; P= 0.92; 5-year OS, 94.5%). Conclusions: For radiologically aggressive small-sized lung cancer, oncologic outcomes of segmentectomy were equivalent to those of lobectomy.

Download Full-text

Computer-aided diagnosis of lung cancer: definition and detection of ground-glass opacity type of nodules by high-resolution computed tomography

Japanese Journal of Radiology ◽

10.1007/s11604-008-0306-z ◽

2009 ◽

Vol 27 (2) ◽

pp. 91-99 ◽

Cited By ~ 15

Author(s):

Tohru Okada ◽

Shingo Iwano ◽

Takeo Ishigaki ◽

Takayuki Kitasaka ◽

Yasushi Hirano ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

High Resolution ◽

Ground Glass Opacity ◽

Computer Aided Diagnosis ◽

Ground Glass ◽

High Resolution Computed Tomography ◽

Computer Aided ◽

Diagnosis Of Lung Cancer ◽

Aided Diagnosis

Download Full-text

Solid tumors versus mixed tumors with a ground-glass opacity component in patients with clinical stage IA lung adenocarcinoma: Prognostic comparison using high-resolution computed tomography findings

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2012.11.019 ◽

2013 ◽

Vol 146 (1) ◽

pp. 17-23 ◽

Cited By ~ 56

Author(s):

Yasuhiro Tsutani ◽

Yoshihiro Miyata ◽

Takeharu Yamanaka ◽

Haruhiko Nakayama ◽

Sakae Okumura ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Lung Adenocarcinoma ◽

Solid Tumors ◽

Clinical Stage ◽

Ground Glass Opacity ◽

High Resolution Computed Tomography ◽

Clinical Stage Ia ◽

Stage Ia ◽

Mixed Tumors

Download Full-text

Prognosis of segmentectomy and lobectomy for radiologically aggressive small-sized lung cancer

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezaa231 ◽

2020 ◽

Vol 58 (6) ◽

pp. 1245-1253 ◽

Cited By ~ 1

Author(s):

Atsushi Kamigaichi ◽

Yasuhiro Tsutani ◽

Takahiro Mimae ◽

Yoshihiro Miyata ◽

Hiroyuki Ito ◽

...

Keyword(s):

Lung Cancer ◽

Tumour Size ◽

Characteristic Curve ◽

Clinical Stage ◽

Multivariable Analysis ◽

Recurrence Free Survival ◽

High Resolution Computed Tomography ◽

Free Survival ◽

Lung Cancers ◽

Positron Emission

Abstract OBJECTIVES The purpose of this study was to determine the radiological characteristics of aggressive small-sized lung cancer and to compare the outcomes between segmentectomy and lobectomy in patients with these lung cancers. METHODS A series of 1046 patients with clinical stage IA1–IA2 lung cancer who underwent lobectomy or segmentectomy at 3 institutions was retrospectively evaluated to identify radiologically aggressive small-sized (solid tumour size ≤ 2 cm) lung cancers. Prognosis of segmentectomy was compared with that of lobectomy in 522 patients with radiologically aggressive small-sized lung cancer using propensity score matching. RESULTS Multivariable analysis showed that increasing consolidation-to-tumour ratio on preoperative high-resolution computed tomography (CT) (P = 0.037) and maximum standardized uptake on 18 fluoro-2-deoxyglucose positron emission tomography/CT (P = 0.029) was independently associated with worse recurrence-free survival. Based on analysis of the receiver operating characteristic curve, radiologically aggressive lung cancer was defined as a radiologically solid (consolidation-to-tumour ratio ≥ 0.8) or highly metabolic (maximum standardized uptake ≥ 2.5) tumour. Among patients with radiologically aggressive lung cancer, no significant statistical differences in 5-year recurrence-free (81% vs 90%; P = 0.33) and overall (88% vs 93%; P = 0.76) survival comparing lobectomy (n = 392) to segmentectomy (n = 130) were observed. Among 115 propensity-matched pairs, 5-year recurrence-free survival and overall survival were similar between patients who underwent lobectomy and those who underwent segmentectomy (83.3% and 88.3% vs 90.9% and 94.5%, respectively). CONCLUSIONS Difference in survival was not identified with segmentectomy and lobectomy in patients with radiologically aggressive small-sized lung cancer with high risk of recurrence.

Download Full-text

P1.13-13 High-Risk Clinical Stage I Non-Small Cell Lung Cancer Based on High-Resolution Computed Tomography Findings

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2019.08.1150 ◽

2019 ◽

Vol 14 (10) ◽

pp. S551

Author(s):

Y. Tsutani ◽

A. Kagimoto ◽

Y. Handa ◽

T. Mimae ◽

Y. Miyata ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

High Risk ◽

High Resolution ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Clinical Stage ◽

Small Cell ◽

Small Cell Lung ◽

High Resolution Computed Tomography

Download Full-text

The New Useful High-Resolution Computed Tomography Finding for Diagnosing Fibrotic Hypersensitivity Pneumonitis: “Hexagonal Pattern”: A Single-Center Retrospective Study

10.21203/rs.3.rs-1077089/v1 ◽

2021 ◽

Author(s):

Hiroko Okabayashi ◽

Taiki Fukuda ◽

Tae Iwasawa ◽

Tsuneyuki Oda ◽

Hideya Kitamura ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Hypersensitivity Pneumonitis ◽

Ground Glass Opacity ◽

High Resolution Computed Tomography ◽

Air Trapping ◽

Hexagonal Pattern ◽

Significant Difference ◽

Tomography Finding ◽

Density Pattern

Abstract Background Centrilobular nodules, ground-glass opacity (GGO), mosaic attenuation, air trapping, and three-density pattern were reported as high-resolution computed tomography (HRCT) findings characteristic of fibrotic hypersensitivity pneumonitis (HP). However, it is often difficult to differentiate fibrotic HP from idiopathic pulmonary fibrosis (IPF). In fibrotic HP, the HRCT sometimes shows tortoiseshell-like interlobular septal thickening that extends from the subpleural lesion to the inner layers. This finding is called “hexagonal pattern,” and this study is focused on the possibility that such finding is useful for differentiating fibrotic HP from IPF. Methods This study included patients with multidisciplinary discussion (MDD) diagnosis of fibrotic HP or IPF undergoing surgical lung biopsy between January 2015 and December 2017 in Kanagawa Cardiovascular and Respiratory Center. Two radiologists have evaluated the HRCT findings without clinical and pathological information. Results A total of 23 patients were diagnosed with fibrotic HP by MDD and 48 with IPF. Extensive GGO, centrilobular nodules, and hexagonal pattern were more frequent findings in fibrotic HP than in IPF. No significant difference was observed between the two groups in the presence or absence of mosaic attenuation, air trapping, or three-density pattern. In the multivariate logistic regression, the presence of extensive GGO and hexagonal pattern was associated with increased odds ratio of fibrotic HP. The sensitivity and specificity of the diagnosis of fibrotic HP in the presence of the hexagonal pattern were 69.6% and 87.5%, respectively. Conclusion Hexagonal pattern is a useful finding for differentiating fibrotic HP from IPF.

Download Full-text

The Role of Transthoracic Ultrasound in the Study of Interstitial Lung Diseases: High-Resolution Computed Tomography Versus Ultrasound Patterns: Our Preliminary Experience

Diagnostics ◽

10.3390/diagnostics11030439 ◽

2021 ◽

Vol 11 (3) ◽

pp. 439

Author(s):

Donato Lacedonia ◽

Giulia Scioscia ◽

Angelamaria Giardinelli ◽

Carla Maria Irene Quarato ◽

Ennio Vincenzo Sassani ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Lung Diseases ◽

Interstitial Lung Diseases ◽

High Resolution Computed Tomography ◽

Pleural Line ◽

Complementary Role ◽

Number Of Patients ◽

Significant Difference ◽

Transthoracic Ultrasound

Transthoracic ultrasound (TUS) is a readily available imaging tool that can provide a quick real-time evaluation. The aim of this preliminary study was to establish a complementary role for this imaging method in the approach of interstitial lung diseases (ILDs). TUS examination was performed in 43 consecutive patients with pulmonary fibrosis and TUS findings were compared with the corresponding high-resolution computed tomography (HRCT) scans. All patients showed a thickened hyperechoic pleural line, despite no difference between dominant HRCT patterns (ground glass, honeycombing, mixed pattern) being recorded (p > 0.05). However, pleural lines’ thickening showed a significant difference between different HRCT degree of fibrosis (p < 0.001) and a negative correlation with functional parameters. The presence of >3 B-lines and subpleural nodules was also assessed in a large number of patients, although they did not demonstrate any particular association with a specific HRCT finding or fibrotic degree. Results allow us to suggest a complementary role for TUS in facilitating an early diagnosis of ILD or helping to detect a possible disease progression or eventual complications during routine clinical practice (with pleural line measurements and subpleural nodules), although HRCT remains the gold standard in the definition of ILD pattern, disease extent and follow-up.

Download Full-text

The Sensitivity and Specificity of a new Scoring System Using High Resolution Computed Tomography to Diagnose Lung Cancer

Medical Journal of Indonesia ◽

10.13181/mji.v18i3.360 ◽

2009 ◽

pp. 181

Author(s):

Arman A. Abdullah ◽

Nurlela Bujang ◽

Cholid Badril ◽

Chairil Hamdani ◽

Purnawan Junadi ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

High Resolution ◽

Sensitivity And Specificity ◽

Scoring System ◽

High Resolution Computed Tomography ◽

Diagnose Lung Cancer ◽

New Scoring

Download Full-text

Features Based on Thin-section Computed Tomography Identify the Typeof lung Adenocarcinoma

10.21203/rs.3.rs-18082/v2 ◽

2020 ◽

Author(s):

Zhiqiang Li ◽

Hongwei Zheng ◽

Shanshan Liu ◽

Xinhua Wang ◽

Lei Xiao ◽

...

Keyword(s):

Computed Tomography ◽

Lung Adenocarcinoma ◽

Thin Section ◽

Ground Glass Opacity ◽

Smoking History ◽

Ground Glass ◽

Quantitative Aspect ◽

Adenocarcinoma In Situ ◽

Invasive Adenocarcinoma ◽

Pleural Invasion

Abstract Background: To investigate whether thin-section computed tomography (TSCT) features may efficiently guide the invasiveness basedclassification of lung adenocarcinoma. Methods: Totally, 316 lung adenocarcinoma patients (from 2011-2015) were divided into three groups: 56 adenocarcinoma in situ (AIS), 98 minimally invasive adenocarcinoma (MIA), and 162 invasive adenocarcinoma (IAC) according their pathological results. Their TSCT features, including nodule pattern, shape, pleural invasion, solid proportion, border, margin, vascular convergence, air bronchograms, vacuole sign, pleural indentation, diameter, solid diameter, and CT values of ground-glass nodules (GGN) were analyzed. Pearson’s chi-square test, Fisher’s exact test and One-way ANOVA were adopted tocomparebetweengroups. Receiver operating characteristic (ROC) analysis wereperformedto assess its value for prediction and diagnosis. Results: Patients with IAC were significantly elder than those in AIS or MIA group,and more MIA patients had a smoking history than AIS and IAC. No recurrence happened in the AIS and MIA groups, while 4.3% recurrences were confirmed in the IAC group. As for TSCT variables, we found AIS group showed dominantly higher 91.07%PGGN pattern and 87.50% round/oval nodules than that in MIA and IAC group. In contrast, MIA group showed more cases with undefined border and vascular convergence than AIS and IAC group. Importantly, IAC group uniquely showed higher frequency of pleural invasion compared with MIA and AIS group. The majority of patients (82.1%) in IAC group showed ≥ 50% solid proportion. We found diameter and solid diameter of the lesions were notably larger in the IAC group compared with AIS and MIA groupin quantitative aspect. In addition, for MGGNs, the CT values of ground-glass opacity (GGO) and ground-glass opacity solid portion (GGO-solid) were both higher in the IAC group than AIS and MIA. Finally, we also observed that smooth margin took a dominant proportion in the AIS group while most cases in the IAC group had a lobulate margin. Patients in MIA and IAC group shared higher level of air bronchograms and vacuole signs than AIS group. Conclusions: The unique features in different groups identified by TSCT had diagnosis value for lung adenocarcinoma.

Download Full-text