The application of subjective assessment, two dimensional measurement and three dimensional measurement in solid component measurement of lung part-solid ground glass nodule_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MA Lin ¹ , GUO Chenglin ¹ , MEI Jiandong ¹ , LIU Chengwu ¹ , LI Weimin ² ,  LIU Lunxu ¹

1. Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, 610041, P.R.China;
2. Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

LIU Lunxu, Email: lunxu_liu@aliyun.com

Keywords：

Lung cancer; computer tomography; ground glass opacity; solid component measurement

DOI：

10.7507/1007-4848.201708056

Video：

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Stage ⅠA lung adenocarcinoma presented as ground glass dominant on thin-section high-resolution CT scan is a special subtype of lung cancer. The characteristics of this subtype are quite different from the other patients, which presented as lower malignancy and better prognosis. Clinical, pathological and imaging studies have revealed that the proportion of the solid component in part-solid ground glass nodule is closely related with the pathological type and the prognosis of lung cancer. The methods for the assessment of the solid components in the ground glass nodule can be classified into three types, including subjective assessment, two dimensional measurement and three dimensional measurement. This review summarized the advantages and the limitations of these three methods. We also reviewed the clinical application of these techniques.

Citation： MA Lin, GUO Chenglin, MEI Jiandong, LIU Chengwu, LI Weimin, LIU Lunxu. The application of subjective assessment, two dimensional measurement and three dimensional measurement in solid component measurement of lung part-solid ground glass nodule. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(7): 622-626. doi: 10.7507/1007-4848.201708056 Copy

1.	Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin, 2013, 63(1): 11-30.
2.	Sone S, Li F, Yang ZG, et al. Results of three-year mass screening programme for lung cancer using mobile low-dose spiral computed tomography scanner. Br J Cancer, 2001, 84(1): 25-32.
3.	Tsutani Y, Miyata Y, Mimae T, et al. The prognostic role of pathologic invasive component size, excluding lepidic growth, in stage Ⅰ lung adenocarcinoma. J Thorac Cardiovasc Surg, 2013, 146(3): 580-585.
4.	Kodama K, Higashiyama M, Yokouchi H, et al. Prognostic value of ground-glass opacity found in small lung adenocarcinoma on high-resolution CT scanning. Lung Cancer, 2001, 33(1): 17-25.
5.	Nakata M, Saeki H, Takata I, et al. Focal ground-glass opacity detected by low-dose helical CT. Chest, 2002, 121(5): 1464-1467.
6.	Asamura H, Hishida T, Suzuki K, et al. Radiographically determined noninvasive adenocarcinoma of the lung: survival outcomes of Japan Clinical Oncology Group 0201. J Thorac Cardiovasc Surg, 2013, 146(1): 24-30.
7.	Tsutani Y, Miyata Y, Nakayama H, et al. Appropriate sublobar resection choice for ground glass opacity-dominant clinical stage ⅠA lung adenocarcinoma: wedge resection or segmentectomy. Chest, 2014, 145(1): 66-71.
8.	Maeshima AM, Tochigi N, Yoshida A, et al. Histological scoring for small lung adenocarcinomas 2 cm or less in diameter: a reliable prognostic indicator. J Thorac Oncol, 2010, 5(3): 333-339.
9.	Austin JH, Garg K, Aberle D, et al. Radiologic implications of the 2011 classification of adenocarcinoma of the lung. Radiology, 2013, 266(1): 62-71.
10.	Godoy MC, Naidich DP. Subsolid pulmonary nodules and the spectrum of peripheral adenocarcinomas of the lung: recommended interim guidelines for assessment and management. Radiology, 2009, 253(3): 606-622.
11.	Kim EA, Johkoh T, Lee KS, et al. Quantification of ground-glass opacity on high-resolution CT of small peripheral adenocarcinoma of the lung: pathologic and prognostic implications. AJR Am J Roentgenol, 2001, 177(6): 1417-1422.
12.	Kondo T, Yamada K, Noda K, et al. Radiologic-prognostic correlation in patients with small pulmonary adenocarcinomas. Lung Cancer, 2002, 36(1): 49-57.
13.	Matsuguma H, Yokoi K, Anraku M, et al. Proportion of ground-glass opacity on high-resolution computed tomography in clinical T1N0M0 adenocarcinoma of the lung: A predictor of lymph node metastasis. J Thorac Cardiovasc Surg, 2002, 124(2): 278-284.
14.	Maeyashiki T, Suzuki K, Hattori A, et al. The size of consolidation on thin-section computed tomography is a better predictor of survival than the maximum tumour dimension in resectable lung cancer. Eur J Cardiothorac Surg, 2013, 43(5): 915-918.
15.	Hwang EJ, Park CM, Ryu Y, et al. Pulmonary adenocarcinomas appearing as part-solid ground-glass nodules: is measuring solid component size a better prognostic indicator? Eur Radiol, 2015, 25(2): 558-567.
16.	Matsuguma H, Nakahara R, Anraku M, et al. Objective definition and measurement method of ground-glass opacity for planning limited resection in patients with clinical stage ⅠA adenocarcinoma of the lung. Eur J Cardiothorac Surg, 2004, 25(6): 1102-1106.
17.	Kakinuma R, Kodama K, Yamada K, et al. Performance evaluation of 4 measuring methods of ground-glass opacities for predicting the 5-year relapse-free survival of patients with peripheral nonsmall cell lung cancer: a multicenter study. J Comput Assist Tomogr, 2008, 32(5): 792-798.
18.	Takamochi K, Nagai K, Yoshida J, et al. Pathologic N0 status in pulmonary adenocarcinoma is predictable by combining serum carcinoembryonic antigen level and computed tomographic findings. J Thorac Cardiovasc Surg, 2001, 122(2): 325-330.
19.	Siegelman JW, Supanich MP, Gavrielides MA. Pulmonary nodules with ground-glass opacity can be reliably measured with low-dose techniques regardless of iterative reconstruction: results of a phantom study. AJR Am J Roentgenol, 2015, 204(6): 1242-1247.
20.	Oda S, Awai K, Murao K, et al. Computer-aided volumetry of pulmonary nodules exhibiting ground-glass opacity at MDCT. AJR Am J Roentgenol, 2010, 194(2): 398-406.
21.	Sumikawa H, Johkoh T, Nagareda T, et al. Pulmonary adenocarcinomas with ground-glass attenuation on thin-section CT: quantification by three-dimensional image analyzing method. Eur J Radiol, 2008, 65(1): 104-111.
22.	Kim H, Park CM, Woo S, et al. Pure and part-solid pulmonary ground-glass nodules: measurement variability of volume and mass in nodules with a solid portion less than or equal to 5 mm. Radiology, 2013, 269(2): 585-593.
23.	Song SH, Ahn JH, Lee HY, et al. Prognostic impact of nomogram based on whole tumour size, tumour disappearance ratio on CT and SUVmax on PET in lung adenocarcinoma. Eur Radiol. 2016;26(6):1538-1546.
24.	Ohtaki Y, Yoshida J, Ishii G, et al. Prognostic significance of a solid component in pulmonary adenocarcinoma. Ann Thorac Surg. 2011;91(4):1051-1057.
25.	Austin JH, Muller NL, Friedman PJ, et al. Glossary of terms for CT of the lungs: recommendations of the Nomenclature Committee of the Fleischner Society. Radiology. 1996;200(2):327-331.
26.	Kuriyama K, Seto M, Kasugai T, et al. Ground-glass opacity on thin-section CT: value in differentiating subtypes of adenocarcinoma of the lung. AJR Am J Roentgenol. 1999;173(2):465-469.
27.	Hwang EJ, Park CM, Ryu Y, et al. 具有部分实性成分磨玻璃结节表现的肺腺癌:实性成分的大小是一项更好的预后指标吗? 国际医学放射学杂志, 2015, 38(2): 203.
28.	Ohde Y, Nagai K, Yoshida J, et al. The proportion of consolidation to ground-glass opacity on high resolution CT is a good predictor for distinguishing the population of non-invasive peripheral adenocarcinoma. Lung Cancer. 2003;42(3):303-310.
29.	Kim H, Park CM, Woo S, et al. 单纯的与部分实性的肺磨玻璃样结节:结节内实性部分≤ 5 mm 者的容积测量差异. 国际医学放射学杂志, 2014, 37(1): 72.
30.	Cha MJ, Lee KS, Kim HS, et al. Improvement in imaging diagnosis technique and modalities for solitary pulmonary nodules: from ground-glass opacity nodules to part-solid and solid no dules. Expert Rev Respir Med. 2016;10(3):261-278.
31.	Kakinuma R, Ashizawa K, Kuriyama K, et al. Measurement of focal ground-glass opacity diameters on CT images: interobserver agreement in regard to identifying increases in the size of ground-glass opacities. Acad Radiol. 2012;19(4):389-394.
32.	Lee KW, Im JG, Kim TJ, et al. A new method of measuring the amount of soft tissue in pulmonary ground-glass opacity nodules: a phantom study. Korean J Radiol. 2008;9(3):219-225.
33.	de Hoop B, Gietema H, van de Vorst S, et al. Pulmonary ground-glass nodules: increase in mass as an early indicator of growth. Radiology. 2010;255(1):199-206.

1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin, 2013, 63(1): 11-30.
2. Sone S, Li F, Yang ZG, et al. Results of three-year mass screening programme for lung cancer using mobile low-dose spiral computed tomography scanner. Br J Cancer, 2001, 84(1): 25-32.
3. Tsutani Y, Miyata Y, Mimae T, et al. The prognostic role of pathologic invasive component size, excluding lepidic growth, in stage Ⅰ lung adenocarcinoma. J Thorac Cardiovasc Surg, 2013, 146(3): 580-585.
4. Kodama K, Higashiyama M, Yokouchi H, et al. Prognostic value of ground-glass opacity found in small lung adenocarcinoma on high-resolution CT scanning. Lung Cancer, 2001, 33(1): 17-25.
5. Nakata M, Saeki H, Takata I, et al. Focal ground-glass opacity detected by low-dose helical CT. Chest, 2002, 121(5): 1464-1467.
6. Asamura H, Hishida T, Suzuki K, et al. Radiographically determined noninvasive adenocarcinoma of the lung: survival outcomes of Japan Clinical Oncology Group 0201. J Thorac Cardiovasc Surg, 2013, 146(1): 24-30.
7. Tsutani Y, Miyata Y, Nakayama H, et al. Appropriate sublobar resection choice for ground glass opacity-dominant clinical stage ⅠA lung adenocarcinoma: wedge resection or segmentectomy. Chest, 2014, 145(1): 66-71.
8. Maeshima AM, Tochigi N, Yoshida A, et al. Histological scoring for small lung adenocarcinomas 2 cm or less in diameter: a reliable prognostic indicator. J Thorac Oncol, 2010, 5(3): 333-339.
9. Austin JH, Garg K, Aberle D, et al. Radiologic implications of the 2011 classification of adenocarcinoma of the lung. Radiology, 2013, 266(1): 62-71.
10. Godoy MC, Naidich DP. Subsolid pulmonary nodules and the spectrum of peripheral adenocarcinomas of the lung: recommended interim guidelines for assessment and management. Radiology, 2009, 253(3): 606-622.
11. Kim EA, Johkoh T, Lee KS, et al. Quantification of ground-glass opacity on high-resolution CT of small peripheral adenocarcinoma of the lung: pathologic and prognostic implications. AJR Am J Roentgenol, 2001, 177(6): 1417-1422.
12. Kondo T, Yamada K, Noda K, et al. Radiologic-prognostic correlation in patients with small pulmonary adenocarcinomas. Lung Cancer, 2002, 36(1): 49-57.
13. Matsuguma H, Yokoi K, Anraku M, et al. Proportion of ground-glass opacity on high-resolution computed tomography in clinical T1N0M0 adenocarcinoma of the lung: A predictor of lymph node metastasis. J Thorac Cardiovasc Surg, 2002, 124(2): 278-284.
14. Maeyashiki T, Suzuki K, Hattori A, et al. The size of consolidation on thin-section computed tomography is a better predictor of survival than the maximum tumour dimension in resectable lung cancer. Eur J Cardiothorac Surg, 2013, 43(5): 915-918.
15. Hwang EJ, Park CM, Ryu Y, et al. Pulmonary adenocarcinomas appearing as part-solid ground-glass nodules: is measuring solid component size a better prognostic indicator? Eur Radiol, 2015, 25(2): 558-567.
16. Matsuguma H, Nakahara R, Anraku M, et al. Objective definition and measurement method of ground-glass opacity for planning limited resection in patients with clinical stage ⅠA adenocarcinoma of the lung. Eur J Cardiothorac Surg, 2004, 25(6): 1102-1106.
17. Kakinuma R, Kodama K, Yamada K, et al. Performance evaluation of 4 measuring methods of ground-glass opacities for predicting the 5-year relapse-free survival of patients with peripheral nonsmall cell lung cancer: a multicenter study. J Comput Assist Tomogr, 2008, 32(5): 792-798.
18. Takamochi K, Nagai K, Yoshida J, et al. Pathologic N0 status in pulmonary adenocarcinoma is predictable by combining serum carcinoembryonic antigen level and computed tomographic findings. J Thorac Cardiovasc Surg, 2001, 122(2): 325-330.
19. Siegelman JW, Supanich MP, Gavrielides MA. Pulmonary nodules with ground-glass opacity can be reliably measured with low-dose techniques regardless of iterative reconstruction: results of a phantom study. AJR Am J Roentgenol, 2015, 204(6): 1242-1247.
20. Oda S, Awai K, Murao K, et al. Computer-aided volumetry of pulmonary nodules exhibiting ground-glass opacity at MDCT. AJR Am J Roentgenol, 2010, 194(2): 398-406.
21. Sumikawa H, Johkoh T, Nagareda T, et al. Pulmonary adenocarcinomas with ground-glass attenuation on thin-section CT: quantification by three-dimensional image analyzing method. Eur J Radiol, 2008, 65(1): 104-111.
22. Kim H, Park CM, Woo S, et al. Pure and part-solid pulmonary ground-glass nodules: measurement variability of volume and mass in nodules with a solid portion less than or equal to 5 mm. Radiology, 2013, 269(2): 585-593.
23. Song SH, Ahn JH, Lee HY, et al. Prognostic impact of nomogram based on whole tumour size, tumour disappearance ratio on CT and SUVmax on PET in lung adenocarcinoma. Eur Radiol. 2016;26(6):1538-1546.
24. Ohtaki Y, Yoshida J, Ishii G, et al. Prognostic significance of a solid component in pulmonary adenocarcinoma. Ann Thorac Surg. 2011;91(4):1051-1057.
25. Austin JH, Muller NL, Friedman PJ, et al. Glossary of terms for CT of the lungs: recommendations of the Nomenclature Committee of the Fleischner Society. Radiology. 1996;200(2):327-331.
26. Kuriyama K, Seto M, Kasugai T, et al. Ground-glass opacity on thin-section CT: value in differentiating subtypes of adenocarcinoma of the lung. AJR Am J Roentgenol. 1999;173(2):465-469.
27. Hwang EJ, Park CM, Ryu Y, et al. 具有部分实性成分磨玻璃结节表现的肺腺癌:实性成分的大小是一项更好的预后指标吗? 国际医学放射学杂志, 2015, 38(2): 203.
28. Ohde Y, Nagai K, Yoshida J, et al. The proportion of consolidation to ground-glass opacity on high resolution CT is a good predictor for distinguishing the population of non-invasive peripheral adenocarcinoma. Lung Cancer. 2003;42(3):303-310.
29. Kim H, Park CM, Woo S, et al. 单纯的与部分实性的肺磨玻璃样结节:结节内实性部分≤ 5 mm 者的容积测量差异. 国际医学放射学杂志, 2014, 37(1): 72.
30. Cha MJ, Lee KS, Kim HS, et al. Improvement in imaging diagnosis technique and modalities for solitary pulmonary nodules: from ground-glass opacity nodules to part-solid and solid no dules. Expert Rev Respir Med. 2016;10(3):261-278.
31. Kakinuma R, Ashizawa K, Kuriyama K, et al. Measurement of focal ground-glass opacity diameters on CT images: interobserver agreement in regard to identifying increases in the size of ground-glass opacities. Acad Radiol. 2012;19(4):389-394.
32. Lee KW, Im JG, Kim TJ, et al. A new method of measuring the amount of soft tissue in pulmonary ground-glass opacity nodules: a phantom study. Korean J Radiol. 2008;9(3):219-225.
33. de Hoop B, Gietema H, van de Vorst S, et al. Pulmonary ground-glass nodules: increase in mass as an early indicator of growth. Radiology. 2010;255(1):199-206.

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