title: Predicting pleural invasion using HRCT and 18F-FDG PET/CT in lung adenocarcinoma with pleural contact.
abstract: OBJECTIVE
  To evaluate the relevance of high-resolution computed tomography (HRCT) findings and fluorine-18-fluorodeoxyglucose ((18)F-FDG) uptake for risk stratification of visceral pleural invasion by lung adenocarcinoma.
  
  
  METHODS
  The HRCT findings and (18)F-FDG uptake for lung adenocarcinomas with pleural contact on CT were retrospectively analyzed in 208 consecutive patients (94 females and 114 males; median age, 69.0 years) between January 2009 and December 2013, with institutional review board approval. The HRCT findings and maximum standardized uptake value (SUV max) were recorded for each patient. Multivariate logistic regression was used for statistical analysis, and subgroup analysis stratified for whole tumor size ≤ 3 cm was also performed.
  
  
  RESULTS
  Multivariate analysis showed that SUV max [odds ratio (OR) 1.09, 95 % confidence interval (CI) 1.02-1.16, P = 0.014] and obtuse angle (OR 4.14, 95 % CI 1.97-8.74, P < 0.001) were significant independent predictors for visceral pleural invasion. Receiver operating characteristic (ROC) analysis showed that, compared with the multivariate models [area under the curve (Az) 0.819-0.829], SUV max alone (Az 0.815) was useful in predicting visceral pleural invasion. In the subgroup analysis, multivariate analysis showed that SUV max (OR 1.29, 95 % CI 1.12-1.50, P = 0.001) and contact length with the pleura (OR 1.13, 95 % CI 1.05-1.22, P = 0.001) were significant independent predictors for visceral pleural invasion. ROC analysis showed that SUV max alone (Az 0.844) showed similar diagnostic performance to the multivariate models (Az 0.845-0.857).
  
  
  CONCLUSIONS
  SUV max alone and multivariate models including SUV max are useful for the prediction of visceral pleural invasion by lung adenocarcinoma.
authors.affiliation: Department of Radiology, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan. p9r543qa@s.okayama-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Radiology, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Shinya
authors.affiliation: Department of Radiology, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Sato
authors.affiliation: Center for Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Mitsuhashi
authors.affiliation: Department of Pathology, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Ichimura
authors.affiliation: Department of General Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Soh
authors.affiliation: Department of General Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Toyooka
authors.affiliation: Okayama Diagnostic Imaging Center, 2-3-25, Daikucho, Okayama, 700-0913, Japan.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Kaji
authors.affiliation: Department of General Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
authors.affiliation: Department of Radiology, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Kanazawa
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009361:Neoplasm Invasiveness; D010994:Pleura; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG; HRCT; Lung adenocarcinoma; PET/CT; Visceral pleural invasion