HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (4) Citing Articles via Google Scholar Google Scholar Articles by Tateishi, U. Articles by Arai, Y. Search for Related Content PubMed PubMed Citation Articles by Tateishi, U. Articles by Arai, Y.

Prediction of Lung Adenocarcinoma Without Vessel Invasion^*

A CT Scan Volumetric Analysis

^* From the Division of Diagnostic Radiology (Drs. Tateishi, Yonemori, Satake, and Arai), National Cancer Center Hospital, Tokyo, Japan; the Department of Biostatistics (Dr. Uno), Harvard School of Public Health, Boston, MA; and the Division of Biostatistics (Takeuchi), Kitasato University Graduate School, Tokyo, Japan.

Correspondence to: Ukihide Tateishi, MD, PhD, Division of Diagnostic Radiology, National Cancer Center Hospital, Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan; e-mail: utateish{at}ncc.go.jp

Study objectives: Patients with lung adenocarcinoma without vessel invasion have a favorable prognosis after resection and are among the candidates for limited surgery. The purpose of the present study was to predict lung adenocarcinoma without vessel invasion based on a volumetric analysis of the lesion with a CT scan prior to the operation.

Methods: CT scan images were obtained in 288 consecutive patients with adenocarcinoma of the lung before surgical resection. Total tumor volume, the volume of the nonsolid component, and the proportion occupied by the nonsolid component were calculated by the perimeter method. The performance of the derived logistic regression model and the volumetric results were evaluated by receiver operating characteristic analysis. The model derived for the prediction of tumors without vessel invasion was assessed by means of the leave-one-out cross-validation technique.

Results: The pathologic diagnosis was adenocarcinoma with vessel invasion in 160 cases, and without vessel invasion in 128 cases. The median total tumor volume, the median volume of the nonsolid component, and median proportion occupied by the nonsolid component were 1,123.7 mm³, 253.4 mm³, and 58.0%, respectively. With the derivation of the predictive rule, stepwise regression yielded the following five features: the proportion occupied by the nonsolid component; spiculation; pleural indentation; gender; and tumor size. The Az value, a measure of diagnostic power represented as the area under the curve, was 0.957 for prediction of lung adenocarcinoma without vessel invasion. The cross-validation accuracy achieved by applying the rule was 90.3%.

Conclusions: The proportion occupied by the nonsolid component based on a CT scan volumetric analysis was a reliable predictor of tumors without vessel invasion in patients with adenocarcinoma of the lung.

Key Words: CT scan • lung • lung cancer

This article has been cited by other articles:

				T. Hashizume, K. Yamada, N. Okamoto, H. Saito, F. Oshita, Y. Kato, H. Ito, H. Nakayama, Y. Kameda, and K. Noda Prognostic Significance of Thin-Section CT Scan Findings in Small-Sized Lung Adenocarcinoma Chest, February 1, 2008; 133(2): 441 - 447. [Abstract] [Full Text] [PDF]