title: Three-Dimensional Ground Glass Opacity Ratio in CT Images Can Predict Tumor Invasiveness of Stage IA Lung Cancer.
abstract: OBJECTIVE
  We investigated the relationship between various parameters, including volumetric parameters, and tumor invasiveness according to the International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification.
  
  
  METHODS
  We retrospectively reviewed 99 patients with completely resected stage IA lung adenocarcinoma. The correlation between several parameters [one-dimensional ground glass opacity (1D GGO) ratio, two-dimensional (2D) GGO ratio, three-dimensional (3D) GGO ratio, 1D solid size, 2D solid size, and 3D solid size] and tumor invasiveness according to IASLC/ATS/ERS classification was investigated using receiver operating characteristic (ROC) analysis. Adenocarcinoma in situ and minimally invasive adenocarcinoma were referred to as noninvasive adenocarcinoma.
  
  
  RESULTS
  The areas under the curve (AUC) to predict invasive adenocarcinoma for the 1D, 2D, and 3D GGO ratios were 0.962, 0.967, and 0.971, respectively. The optimal cut-off values for the 1D, 2D, and 3D GGO ratios were 38%, 62%, and 74%, respectively. The AUC values for 1D, 2D, and 3D solid sizes to predict invasive adenocarcinoma were 0.933, 0.944, and 0.903, respectively. The optimal cut-off values for 1D, 2D, and 3D solid sizes were 1.2 cm, 1.5 cm², and 0.7 cm³, respectively. The difference in the ROC curves for 3D GGO ratio and 3D solid size was significant (p=0.01).
  
  
  CONCLUSIONS
  Computed tomography image-related parameters based on GGO were well correlated with and predictive of invasiveness according to IASLC/ATS/ERS classification. 3D GGO ratio was more strongly correlated with pathologic invasiveness than 3D solid size.
authors.affiliation: Department of Thoracic Surgery, Armed Forces Capital Hospital, Seongnam, Korea.|Department of Medicine, The Graduate School of Yonsei University, Seoul, Korea.
authors.forename: Woo Sik
authors.initials: WS
authors.lastname: Yu
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sae Rom
authors.initials: SR
authors.lastname: Hong
authors.affiliation: Department of Thoracic and Cardiovascular Surgey, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jin Gu
authors.initials: JG
authors.lastname: Lee
authors.affiliation: Department of Pathology, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgey, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hee Suk
authors.initials: HS
authors.lastname: Jung
authors.affiliation: Department of Thoracic and Cardiovascular Surgey, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dae Joon
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgey, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyung Young
authors.initials: KY
authors.lastname: Chung
authors.affiliation: Department of Thoracic and Cardiovascular Surgey, Yonsei University College of Medicine, Seoul, Korea. CYLEECS@yuhs.ac.
authors.forename: Chang Young
authors.initials: CY
authors.lastname: Lee
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
keywords: Adenocarcinoma of lung; neoplasm invasiveness; receiver operating characteristic; volumetric computed tomography