title: Quantitative Computed Tomography Features for Predicting Tumor Recurrence in Patients with Surgically Resected Adenocarcinoma of the Lung.
abstract: The purpose of this study was to determine if preoperative quantitative computed tomography (CT) features including texture and histogram analysis measurements are associated with tumor recurrence in patients with surgically resected adenocarcinoma of the lung.
  
  
  
  The study included 194 patients with surgically resected lung adenocarcinoma who underwent preoperative CT between January 2013 and December 2013. Quantitative CT feature analysis of the lung adenocarcinomas were performed using in-house software based on plug-in package for ImageJ. Ten quantitative features demonstrating the tumor size, attenuation, shape and texture were extracted. The CT parameters obtained from 1-mm and 5-mm data were compared using intraclass correlation coefficients. Univariate and multivariable logistic regression methods were used to investigate the association between tumor recurrence and preoperative CT findings.
  
  
  
  The 1-mm and 5-mm data were highly correlated in terms of diameter, perimeter, area, mean attenuation and entropy. Circularity and aspect ratio were moderately correlated. However, skewness and kurtosis were poorly correlated. Multivariable logistic regression analysis revealed that area (odds ratio [OR], 1.002 for each 1-mm2 increase; P = 0.003) and mean attenuation (OR, 1.005 for each 1.0-Hounsfield unit increase; P = 0.022) were independently associated with recurrence. The receiver operating curves using these two independent predictive factors showed high diagnostic performance in predicting recurrence (C-index = 0.81, respectively).
  
  
  
  Tumor area and mean attenuation are independently associated with recurrence in patients with surgically resected adenocarcinoma of the lung.
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul, Korea.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Koo
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul, Korea.
authors.forename: Yu Sub
authors.initials: YS
authors.lastname: Sung
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul, Korea.
authors.forename: Woo Hyun
authors.initials: WH
authors.lastname: Shim
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul, Korea.|Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Oncology, Asan Medical Center, Seoul, Korea.|Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Chang-Min
authors.initials: CM
authors.lastname: Choi
authors.affiliation: Thoracic and Cardiovascular Surgery, Asan Medical Center, Seoul, Korea.
authors.forename: Hyeong Ryul
authors.initials: HR
authors.lastname: Kim
authors.affiliation: Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jung Bok
authors.initials: JB
authors.lastname: Lee
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul, Korea.
authors.forename: Mi Young
authors.identifier: 0000-0001-5640-3835
authors.initials: MY
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography; D012372:ROC Curve; D012008:Recurrence; D014057:Tomography, X-Ray Computed / Q000379:methods