title: HRCT features distinguishing pre-invasive from invasive pulmonary adenocarcinomas appearing as ground-glass nodules.
abstract: OBJECTIVE
  To investigate the high-resolution computed tomography (HRCT) features that distinguish lung adenocarcinomas in situ (AISs) and minimally invasive adenocarcinomas (MIAs) from invasive adenocarcinomas (IACs) appearing as ground-glass nodules (GGNs), and to select candidates for sublobar resection.
  
  
  METHODS
  Two hundred and twenty-nine patients with 237 GGNs of less than 2 cm (139 AIS-MIA nodules and 98 IAC nodules) confirmed by surgery and pathology were retrospectively reviewed. The HRCT features of the AIS-MIAs and IACs were analysed and compared. Receiver operating characteristic (ROC) analyses were conducted to determine the cutoff values for the qualitative variables and their diagnostic performances.
  
  
  RESULTS
  Significant differences were found in the density, nodule and solid component diameters, CT values of the ground-glass and solid components, lobulated shape, spiculated margin, abnormal pulmonary vein and artery, air bronchogram, and pleural indentation of the GGNs between the two groups. Multivariate and ROC analyses revealed that larger diameter of nodules (≥12.2 mm) and solid components (≥6.7 mm), and higher CT values of the solid components (≥ -192 HU) in the GGNs with air bronchogram were significantly associated with IACs.
  
  
  CONCLUSIONS
  HRCT can identify distinguishing morphological features between AIS-MIAs and IACs, and is helpful for selecting candidates for sublobar resection.
  
  
  CONCLUSIONS
  • IACs appearing as GGNs were often ≥ 12.2 mm in diameter. • IACs were often ≥ 6.7 mm in solid component diameter. • The solid components of the IACs often exhibited ≥ -192 HU. • IACs exhibited air bronchogram more frequently than AIS-MIAs.
authors.affiliation: Department of Radiology, Jinshan Hospital & Shanghai Medical College, Fudan University, Shanghai, 201508, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Radiology, Jinshan Hospital & Shanghai Medical College, Fudan University, Shanghai, 201508, China. dr.jinweiqiang@163.com.
authors.forename: Jin Wei
authors.initials: JW
authors.lastname: Qiang
authors.affiliation: Department of Radiology, Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China. yejianding@126.com.
authors.forename: Jian Ding
authors.initials: JD
authors.lastname: Ye
authors.affiliation: Department of Pathology, Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China.
authors.forename: Rui Ying
authors.initials: RY
authors.lastname: Zhao
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging* / Q000473:pathology*; D009361:Neoplasm Invasiveness; D012372:ROC Curve; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Adenocarcinoma; Adenocarcinoma in situ; Ground-glass nodule; Invasive; Lung neoplasms; Tomography; X-ray computed