title: Correlation between histological invasiveness and the computed tomography value in pure ground-glass nodules.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the correlation between histological invasiveness and the computed tomography (CT) value and size in pure ground-glass nodules (GGNs) to determine optimal "follow-up or resection" strategies.
  
  
  METHODS
  Between 2001 and 2014, 78 resected, pure GGNs were retrospectively evaluated. The maximum diameter and CT value of pure GGNs were measured using a computer graphics support system.
  
  
  RESULTS
  All GGNs with a maximum diameter ≤10 mm and CT value ≤-600 Hounsfield units (HU) were considered to be noninvasive lesions, while 21 of 26 (81 %) with a maximum diameter >10 mm and CT value >-600 HU were considered to be invasive lesions. With respect to the correlation between each histological type and pure GGN with a maximum diameter ≤10 mm and CT value ≤-600 HU, the specificity was 90 % and the sensitivity and negative predictive value were both 100 % in atypical adenomatous hyperplasia (AAH), while the specificity was 58 % and the sensitivity and positive predictive value were 0 % in minimally invasive and invasive adenocarcinoma.
  
  
  CONCLUSIONS
  Pure GGNs with a maximum diameter of ≤10 mm and CT value of ≤-600 HU are nearly always pre-invasive lesions; therefore, surgery should be carefully selected in such patients.
authors.affiliation: Respiratory Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuzuki-ku, Yokohama-City, 224-8503, Japan. akitami@med.showa-u.ac.jp.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kitami
authors.affiliation: Respiratory Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuzuki-ku, Yokohama-City, 224-8503, Japan.
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Sano
authors.affiliation: Respiratory Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuzuki-ku, Yokohama-City, 224-8503, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Hayashi
authors.affiliation: Respiratory Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuzuki-ku, Yokohama-City, 224-8503, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Respiratory Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuzuki-ku, Yokohama-City, 224-8503, Japan.
authors.forename: Shugo
authors.initials: S
authors.lastname: Uematsu
authors.affiliation: Respiratory Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuzuki-ku, Yokohama-City, 224-8503, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Kamio
authors.affiliation: Respiratory Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuzuki-ku, Yokohama-City, 224-8503, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Division of Chest Surgery, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Kadokura
authors.affiliation: Department of Clinical Diagnostic Pathology, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Omatsu
authors.affiliation: Department of Clinical Diagnostic Pathology, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kunimura
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Computed tomography; Diagnosis; Lung cancer; Surgery