title: CT findings of persistent pure ground glass opacity: can we predict the invasiveness?
abstract: BACKGROUND
  To investigate whether CT findings can predict the invasiveness of persistent cancerous pure ground glass opacity (pGGO) by correlating the CT imaging features of persistent pGGO with pathological changes.
  
  
  METHODS
  Ninety five patients with persistent pGGOs were included. Three radiologists evaluated the morphologic features of these pGGOs at high resolution CT (HRCT). Binary logistic regression was used to assess the association between CT findings and histopathological classification (pre-invasive and invasive groups). Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of diameters.
  
  
  RESULTS
  A total of 105 pGGOs were identified. Between pre-invasive (atypical adenomatous hyperplasia, AAH, and adenocarcinoma in situ, AIS) and invasive group (minimally invasive adenocarcinoma, MIA and invasive lung adenocarcinomas, ILA), there were significant differences in diameter, spiculation and vessel dilatation (p<0.05). No difference was found in air-bronchogram, bubble- lucency, lobulated-margin, pleural indentation or vascular convergence (p>0.05). The optimal threshold value of the diameters to predict the invasiveness of pGGO was 12.50mm.
  
  
  CONCLUSIONS
  HRCT features can predict the invasiveness of persistent pGGO. The pGGO with a diameter more than 12.50mm, presences of spiculation and vessel dilatation are important factors to differentiate invasive adenocarcinoma from pre-invasive cancerous lesions.
authors.affiliation: Department of Radiology, Shandong Cancer Hospital and Institute, Jining, China E-mail : huangyongzhuren@163.com.
authors.forename: Li-Heng
authors.initials: LH
authors.lastname: Liu
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.forename: Ran
authors.initials: R
authors.lastname: Wei
authors.forename: Er-Hu
authors.initials: EH
authors.lastname: Jin
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Liu
authors.forename: Liang
authors.initials: L
authors.lastname: Xu
authors.forename: Wen-Wu
authors.initials: WW
authors.lastname: Li
authors.forename: Yong
authors.initials: Y
authors.lastname: Huang
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D012372:ROC Curve; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed