Distribution-and-analysis-of-chest-radiographic-findings-in-covid19-positive-symptomatic-and-asymptomatic-patients—analysis-of-668-patients-in-india

Current COVID-19 radiological literature is dominated by CT and a detailed description of chest x-ray (CXR) appearances in relation to the disease time course is lacking. However, it poses a great challenge on the radiology department, as it is difficult to decontaminate entire CT suite(Zhao et al., 2020)11. This study is aimed to correlate clinical symptoms with the chest X-ray findings in COVID positive patients and to calculate the sensitivity and specificity of chest x ray in diagnosing COVID 19. The present study compares frequency and distribution of chest radiographic findings in COVID 19 positive symptomatic and asymptomatic patients. Patients with a RT-PCR-positive results for COVID 19 infection were 668. Of these, 437 were males (65.4%), 230 females (34.4%) and 1 transgender (0.04%) with a mean age of 44 years (range 2–87 years). Only 18 CXRs were negative for radiological thoracic involvement (6.4%) among symptomatic patients (280). Among the baseline CXR of 668 patients, 375 (56.1%) were normal and 293 (43.8%) were abnormal. Sensitivity and specificity of CXR were 93.91% and 93.3% respectively. Positive and negative predictive values were 90.97% and 95.51% respectively. We found a statistically significant relationship between CXR severity score and age, symptoms, death (P<0.001).We even found significant relationship between age and symptoms, death of COVID positive patients (P<0.001). The relationship between CXR severity and gender, age and gender were not significant (P=0.539, P=0.864 respectively)

Clinical diagnosis and treatment of multiple pulmonary nodules / 中华肿瘤杂志

CT screening has markedly reduced the lung cancer mortality in high-risk population and increased the detection of early-stage pulmonary neoplasms, including multiple pulmonary nodules, especially those with a ground-glass appearance on CT. Multiple primary lung cancer (MPLC) constitutes a specific subtype of lung cancer with indolent biological behaviors, which is predominantly early-stage adenocarcinoma. Although MPLC progresses slowly with rare lymphatic metastasis, existence of synchronous lesions and distributed location of these nodules still pose difficulty for the management of such patients. One single operation is usually insufficient to eradicate all neoplastic lesions, whereas repeated surgical procedures bring about another dilemma: whether clinical benefits of surgical treatment outweigh loss of pulmonary function following multiple operations. Therefore, despite the anxiety for treatment among MPLC patients, whether and how to treat the patient should be assessed meticulously. Currently there is a heated discussion upon the timing of clinical intervention, operation mode and the application of local therapy in MPLC. Based on clinical experience of our multiple disciplinary team, we have summarized and commented on the evaluation, surgical treatment, non-surgical local treatment, targeted therapy and immunotherapy of MPLC in this article to provide further insight into this field.

Personalized treatment strategy for ground-glass opacity-featured lung cancer / 中国胸心血管外科临床杂志

@#Along with the popularity of low-dose computed tomography lung cancer screening, an increasing number of lung ground-glass opacity (GGO) lesions are detected. The pathology of GGO could be benign, but persistent GGO indicates early-stage lung cancer. Distinct from traditional lung cancer, GGO-featured lung cancer is more common in the young, nonsmokers and females. GGO-featured lung cancer represents an indolent type of malignancy with a long time to intervene. However, there is still no consensus on the screening, pathology, surgical procedure, and postoperative surveillance of GGO-featured lung cancer. Therefore, we proposed a personalized treatment strategy for GGO-featured lung cancer. The screening for GGO-featured lung cancer should be conducted at young age and low frequency. Adenocarcinoma in situ, minimally invasive adenocarcinoma, lepidic, and non-lepidic growth patterns could present as GGO. The following issues should be taken into consideration while determining the treatment of GGO-featured lung cancer: avoiding treating benign disease as malignancies, avoiding treating early-stage disease as advanced-stage disease, avoiding treating indolent malignancy as aggressive malignancy, and choosing appropriate timing to receive surgery without affecting life tracks and career developments. Bronchoscope and bone scan are not necessary for preoperative examinations of GGO-featured lung adenocarcinoma. For selected patients, sublobar resection without mediastinal lymph node dissection might be sufficient. Intraoperative frozen section is an effective method to guide resection strategy. Given the excellent survival of GGO-featured lung cancer, a less intensive postoperative surveillance strategy may be sufficient.

Analysis of a surgical series of patients with synchronous multiple ground-glass nodules / 中国胸心血管外科临床杂志

@#Objective    To summarize the clinical experience of surgical resection of synchronous multiple ground-glass nodules (SMGN), and explore the individualized diagnosis and treatment strategy of SMGN. Methods    Clinical data of 84 patients with SMGN who underwent thoracic surgery in Anhui Chest Hospital from July 2016 to August 2018 were analyzed retrospectively, including 18 males (21.4%) and 66 females (78.6%), aged 32-80 (55.6±10.3) years. The results of operation and the information of GGNs were analyzed. Results    Except for 1 patient who was converted to thoracotomy due to extensive dense adhesion of thoracic, other patients underwent video-assisted thoracoscopic surgery successfully. All patients recuperated successfully after operation, without severe perioperative complications or death. Finally, 79 patients were diagnosed as malignant tumors (94.0%), and 5 patients of benign lesions (6.0%). A total of 240 GGNs were removed, among which there were 168 pGGNs, including 68 benign lesions (40.5%) and 100 malignant tumors (59.5%), and 72 mGGNs, including 2 benign nodules (2.8%) and 70 malignant tumors (97.2%). Nodules diameter (P<0.001), consolidation/maximum diameter of nodule ratio (P<0.001), vacuole sign (P<0.001), air bronchograms sign (P=0.001), spine-like process (P=0.001), pleural indentation sign (P<0.001), lobulation sign (P<0.001), and vascular convergence (P=0.002) were correlated with malignant tumor. Conclusion    Analysis of the imaging features of GGNs by thin-section CT scan and three-dimensional reconstruction is of great value in predicting the benign and malignant nodules, which can guide the surgical decision-making and preoperative planning. Through reasonable preoperative planning and following certain principles, simultaneous surgical treatment for SMGN is safe and feasible.

Perioperative and long-term outcomes of segmentectomy for ground-glass opacity dominant early stage lung cancer: A single-center large-sample retrospective analysis / 中国胸心血管外科临床杂志

@#Objective     To summarize the perioperative and long-term outcomes of ground-glass opacity (GGO) dominant early stage lung cancer patients treated by anatomic segmentectomy. Methods     We collected clinical data of 756 patients from Western China Lung Cancer Database, who underwent intentional anatomic segmentectomy [tumor size (T) ≤ 2 cm, GGO ≥ 50%] in the Department of Thoracic Surgery, West China Hospital, Sichuan University from 2009 to 2018. There were 233 males and 523 females at a median age of 53 (25-83) years including 290 (38.4%) patients of simple segmentectomy and 466 (61.6%) patients of complex segmentectomy. All patients were diagnosed as adenocarcinoma, including 338 (44.7%) patients of minimally invasive adenocarcinoma and 418 (55.3%) patients of invasive adenocarcinoma. Results     The median operative time was 115 (38-300) min, the median blood loss was 20 (5-800) mL, 58 (7.7%) patients had postoperative complications and the postoperative stay was 4 (2-24) days. The median follow-up period was 43.0 (30.1-167.9) months. Five-year overall survival rate was 99.5% [95%CI (98.8%, 100.0%)], 5-year recurrence-free survival rate was 98.8% [95%CI (97.5%, 100.0%)], and 5-year lung cancer-specific survival rate was 100.0%. Conclusion    Anatomic segmentectomy has favorable perioperative outcomes and excellent prognosis in GGO dominant early stage lung cancer patients.

Predictive value of radiological features on spread through air spaces in stage cⅠA lung adenocarcinoma with predominant ground-glass opacity / 中国胸心血管外科临床杂志

@#Objective    To investigate the predictive value of preoperative radiological features on spread through air spaces (STAS) in stage cⅠA lung adenocarcinoma with predominant ground-glass opacity, and to provide a basis for the selection of surgical methods for these patients. Methods    The clinical data of 768 patients with stage cⅠA lung adenocarcinoma undergoing operation in our hospital from 2017 to 2018 were reviewed, and 333 early stage lung adenocarcinoma patients with predominant ground-glass opacity were selected. There were 92 males and 241 females, with an average age of 57.0±10.0 years. Statistical analysis was performed using SPSS 22.0. Results    STAS-positive patients were mostly invasive adenocarcinoma (P=0.037), and had more micropapillary component (P<0.001) and more  epidermal growth factor receptor (EGFR) gene mutations (P=0.020). There were no statistically significant differences between the STAS-positive and STAS-negative patients in other clinicopathological features. Univariate analysis showed that the maximum diameter of tumor in lung window (P=0.029), roundness (P=0.035), maximum diameter of solid tumor component in lung window (P<0.001), consolidation/tumor ratio (CTR, P<0.001), maximum area of the tumor in mediastinum window (P=0.001), tumor disappearance ratio (TDR, P<0.001), average CT value (P=0.001) and lobulation sign (P=0.038) were risk factors for STAS positive. Multivariate logistic regression analysis showed that the CTR was an independent predictor of STAS (OR=1.05, 95%CI 1.02 to 1.07, P<0.001), and the area under the receiver operating characteristic (ROC) curve was 0.71 (95%CI 0.58 to 0.85, P=0.002). When the cutoff value was 19%, the sensitivity of predicting STAS was 66.7%, and the specificity was 75.2%. Conclusion    CTR is a good radiological feature to predict the occurrence of STAS in early lung adenocarcinoma with predominant ground-glass opacity. For the stage cⅠA lung adenocarcinoma with predominant ground-glass opacity and CTR ≥19%, the possibility of STAS positive is greater, and sublobar resection needs to be carefully considered.

Clinical and CT manifestations of coronavirus disease 2019 / 西安交通大学学报(医学版)

Objective To evaluate the clinical and CT manifestations of coronavirus disease 2019 (COVID-19). Methods Serial clinical and CT data of 11 patients with confirmed COVID-19 were retrospectively analyzed. These data were collected in The Second Affiliated Hospital of Xi'an Jiaotong University from January 24 to February 9, 2020. There were 6 males and 5 females, aged from 17 to 64 years old, with the mean age of 42.27±15.67. Results A majority of the patients fell into mild type and only one was of severe type. Clinical manifestations were mainly fever, fatigue, and dry cough. For laboratory tests, the patients' lymphocyte and eosinophil counts decreased, while their C-reactive protein concentration increased. In terms of CT findings, 7 patients showed bilateral subpleural involvement. The ground glass opacity (GGO) was common in CT findings. Typical crazy paving sign, air bronchogram and halo sign were also found. During the progression of the disease, GGO might be associated with pulmonary consolidation. No enlarged lymph nodes or pleural effusion were seen in all the patients. Conclusion Patients with COVID-19 have distinctly characteristic chest CT manifestations and laboratory examination findings, which play a vital role in diagnosis and prognosis of the disease.

Chest CT comparison of ground glass opacity-like 2019 novel coronavirus pneumonia and early-stage lung carcinoma / 中国胸心血管外科临床杂志

@#Objective    To investigate CT image features of ground glass opacity (GGO)-like 2019 novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) and early-stage lung carcinoma for control and therapy of this acute severe respiratory disease. Methods    We retrospectively analyzed the clinical data of 71 GGO-like COVID-19 patients who received therapy in Tongji Hospital of Huazhong University of Science and Technology between January 17th and February 13th, 2020. These 71 GGO-like COVID-19 patients were as a COVID-19 group. And 80 GGO-like early-stage lung carcinoma patients who underwent resection were as a lung carcinoma group. Clinical features such as sex, age, symptoms including fever, cough, fatigue, myalgia and dyspnea, detailed exposure history, confirmatory test (SARS-CoV-2 quantitative RT-PCR) and pathologic diagnosis were analyzed. Results    Significantly different symptoms and exposure history between the two groups were detected (P<0.001). More lesions (61 patients at percentage of 85.92%, P<0.001), relative peripheral locations (69 patients at percentage of 97.18%, P<0.001) and larger opacities (65 patients at percentage of 91.55%, P<0.001) were found in chest radiographs of GGO-like COVID-19 compared with GGO-like early-stage lung carcinoma. Similar features appeared in early-stage of COVID-19 and lung carcinoma, while pneumonia developed into more extensive and basal predominant lung consolidation. Coexistence of GGO-like COVID-19 and early-stage lung carcinoma might occur. Conclusion    Considering these similar and unique features of GGO-like COVID-19 and early-stage lung carcinoma, it is necessary to understand short time re-examination of chest radiographs and other diagnostic methods of these two diseases. We believe that the findings reported here are important for diagnosis and control of COVID-19 in China.

Single-stage resection of multiple pulmonary ground-glass opacities: A clinical analysis / 中国胸心血管外科临床杂志

@#Objective    To summarize our experience of surgical resection of multiple ground-glass opacity (GGO) in recent years. Methods    Clinical data of patients who underwent one-stage resections of multiple GGO from November 2015 to May 2019 in our hospital were collected, including 13 males and 52 females at an average age of 56.0±9.4 years. The clinical effects and pathological types of GGO were evaluated. Results    Time interval from first discovery to surgery was 8-1 447 (236.5±362.4) days. There were 48 patients with unilateral surgery and 17 patients with bilateral surgery during the same period. Except for 2 patients who underwent open thoracotomy due to total thoracic adhesions, other patients underwent video-assisted thoracoscopic surgery (VATS). The mean postoperative hospital stay was 12.2±4.3 days. No severe perioperative complication or death occurred. A total of 156 GGO lesions were resected, 80 lesions were pure GGO, including 58 (72.5%) malignant lesions and 22 (27.5%) benign lesions, with an average diameter of 7.7±3.3 mm and 5.5±2.6 mm, respectively. Another 76 lesions were mixed GGO, including 69 (90.8%) malignant lesions and 7 (9.2%) benign lesions, with an average diameter of 13.6±6.6 mm and 7.7±3.5 mm, respectively. Conclusion    Patients with multiple GGO should be treated with anti-inflammatory therapy firstly. When conservative treatment is ineffective and no benign outcomes are observed, surgical treatment should be considered. And when lung function is sufficient for patients to underwent surgeries, the simultaneous unilateral or bilateral thoracoscopic resection is suggested, and the sublobar resection or lobectomy methods can be adopted flexibly according to the clinical features of the lesion and the rapid pathological results, which will not increase the risk of postoperative complications. Otherwise, surgical resection should be given priority for pure GGO lesions with a diameter > 7.7 mm and mixed GGO lesions.

Spectral CT plain multi-parameter imaging in differentiating pathological subtypes of pure ground glass opacity lung adenocarcinoma / 中国医学影像技术

Objective: To explore the value of spectral CT plain multi-parameter imaging in judging pathological subtypes of lung adenocarcinoma with pure ground glass nodule (pGGN). Methods: Forty-five patients with pathological confirmed lung adenocarcinoma manifested as pGGN on spectral plain CT scan images were included and divided into group A (non IAC group, including 9 patients of situ adenocarcinoma [AIS] and 12 of microinvasive adenocarcinoma [MIA] ) and group B (invasive adenocarcinoma group, including 24 IAC patients). Monochromatic images at 70 keV with 40% adaptive statistical iterative reconstruction V (ASIR-V) were reconstructed and qualitative analyzed, including the lobulated sign, burr sign, vacuole sign, air bronchial sign as well as pleural indentation sign and abnormal vascular sign. Quantitative parameters, including CT values on monochromatic images raining from 40 keV to 140 keV, water concentration (WC), effective atomic number (Eff-Z) and spectral curve slope of k1-k3 (represent the slope of 40-70 keV, 71-100 keV, 101-140 keV respectively) were obtained and compared between 2 groups. Results: The occurrence rate of abnormal vascular sign in group B was higher than that in group A (P0.05). The k1 in group B was lower than that in group A (P0.05). The WC of group B was higher than that of group A (P0.05). Conclusion: Spectral CT plain multi-parameter imaging can provide a variety of quantitative parameters based on the morphological features of pGGN and more diagnostic information than routine CT, which is helpful to judging pathological subtypes of lung adenocarcinoma manifested as pGGN.

Spectrum of HRCT findings in interstitial lung diseases and their correlation with mediastinal lymphadenopathy

Background: Interstitial lung disease (ILD) represents a heterogeneous non-infectious group of acute and chronic diseases affecting the lung parenchyma. ILDs are usually associated with significant morbidity and mortality, particularly when fibrosis occurs. ILD is usually associated with mediastinal lymph node enlargement, the extent of lymph node enlargement may correlate to disease activity or progression of fibrosis. In the present study, authors have correlated the spectrum of high-resolution CT findings in ILDs with mediastinal lymph node enlargements.Methods: One hundred and four cases of ILDs confirmed by HRCT findings and pulmonary function tests were included in this study. HRCT was performed using a GE 128 SLICE CT OPTIMA 660 scanner, USA with 1.5 mm collimation at full inspiration. The findings were classified into three groups-fibrotic, ground glassing and nodular pattern. Authors assessed the presence, number and sites of enlarged lymph nodes (short axis ≥10 mm in diameter).Results: The largest subsets of patients were found in the 51-60 age groups. Fibrotic pattern was the most common pattern in this study (50%) followed by ground glassing (44%). Nodular pattern was the least predominant pattern (6%). Lymphadenopathy was seen in 84% of UIP and 63% cases of NSIP. P value was 0.049 which indicates a significant relation between lymphadenopathy and various ILDs. A strong relationship between lymphadenopathy and the predominant fibrotic pattern followed by ground glassing was observed.Conclusions: A significant association was established between lymphadenopathy and the type of ILD where fibrotic pattern had the maximum association.

Computed tomography-guided percutaneous cryoablation for lung ground-glass opacity: A pilot study

Context: Ground-glass opacity (GGO) is a nonspecific imaging parameter for early-stage pulmonary cancer. In these cases, a definite diagnosis and prompt surgery usually yield satisfactory outcomes. Aims: This study aimed to assess the safety and feasibility of cryoablation treatment for lung GGO. Subjects and Methods: We reviewed the clinical data of 14 patients (19 lung tumors) with lung GGO and evaluated the adverse events, lung function, and treatment efficacy after cryoablation. Statistical Analysis Used: Statistical analyses were performed using the Statistical Package for the Social Sciences software (version 13.0; SPSS Inc., Chicago, IL, USA). Results: None of the patients exhibited serious complications, and lung function recovered to >95% after 1 month. During a follow-up, computed tomography scan at 24 months, the GGO appeared to have been successfully ablated in all patients. Conclusion: Cryoablation may serve as a safe and feasible option for the treatment of GGO.

High-Resolution Computed Tomography Lung Spectrum In Symptomatic Adult Hiv-Positive Patients In Correlation With Cd-4 Count

Context: Pulmonary disease accounts for 30–40% of the acute hospitalizations of HIV-positive patients. The CD4 count, anindicator of the severity of immune compromise, is of paramount importance for rendering an appropriate differential diagnosis.High-resolution computed tomography (HRCT) of lung provides detailed visualization of lung parenchyma and can characterizediseases according to pattern and distribution which can help in formulating a differential diagnosis.Aims: The aims of this study were as follows: (1) To identify the radiological appearance/pattern of HIV-associated infections.(2) To correlate the radiological findings with CD4 count.Settings and Design: This was a cross-sectional study using sample size of 100 HIV-infected patients conducted at theDepartment of Radiodiagnosis and Imaging, Gandhi Medical College and Hamidia Hospital, Bhopal.Materials and Methods: A total of 100 adult HIV-infected patients were scanned with HRCT chest and findings were documentedand correlated with their CD4+ counts.Statistical Analysis Used: Data analysis was done using SPSS 21.0. Two-tailed P < 0.05 was considered statistically significant.Results: TB (70%) was the most common infection followed by bacterial pneumonia (14%) and Pneumocystis jiroveci pneumonia(6%). Tuberculosis was found in 29% of advance CD4 count patients and 27% of severe CD4 count patients. Consolidation,airspace nodules, miliary nodules, diffuse ground-glass opacity, and pleural effusion showed significant correlation with CD4counts.Conclusions: Incidence of all these manifestations fairly correlates with the decline of CD4 counts. Early and proper diagnosisof these pulmonary complications in patients with HIV infection and lower CD4 counts will help clinicians to develop a focusedtherapeutic approach in their management.

Appcation of detection of circulating tumor cells and exosome mir-21 in diagnosis of lung ground glass opacity / 吉林大学学报(医学版)

Objective: To evaluate the practicability and feasibility of detection of circulating tumor cells (CTC) combined with exosome miR-21 in the diagnosis of ground glass opacity (GGO), and to provide the evidence for the diagnosis of GGO. Methods: Seventy patients were selected according to the diagnostic and exclusion criteria of GGO. All the patients underwent thoracoscopic segmentectomy. The patients diagnosed as lung cancer after operation were regarded as case group (n=24), and the patients diagnosed as benign lesion after operation were regarded as control group (n=46). Before operation, CTC was captured from the peripheral blood by negative enrichment of immunomagnetic beads. CTC was labeled with tumor-specific folate ligand-oligonucleotide conjugate. The exosomes of the same specimen were detected, purified and identified, and the expression levels of serum exosome miR-21 of the patients in two groups were detected. The diagnostic efficacies of CTC and exosome miR-21 in the GGO paitents were evaluated by ROC curves. Results: The positive rate of CTC in the patients in case group was higher than that in control group (P0. 05). The purified samples showed exosome characteristics. The expression level of serum exosome miR-21 in the patients in case group was higher than that in control group (P<0. 05). The area under ROC curve (AUC) of CTC was 0. 891, and the AUC of exosome miR-21 was 0.711, which showed good specificity. The sensitivity and specificity of the combined detection were 85.64% and 86.79%, respectively. Conclusion: The detection of CTC combined with exosome miR-21 can be used in the clinical diagnosis of early lung cancer with high sensitivity and specificity.

The advancements in the relationship between imaging features of lung-ground glass opacity and prognosis of lung adenocarcinoma / 中国胸心血管外科临床杂志

@#With the development of technology, the detection rate of ground-glass opacity (GGO) is rapidly increasing. GGO comprises of pure GGO and mixed GGO. Many researches have studied the characteristics of GGO, and they found that different malignant probability of GGO was associated with different image characteristics. It is obvious that there is a close relationship between the image characteristics of GGO and its prognosis. However, due to the various image characteristics of GGO, it is essential to assess the prognosis of lung adenocarcinoma patients in a more comprehensive way. In this review, we summarize the correlation between the main GGO image features (solid proportion, size, mean CT value, shape characteristics) and the prognosis of lung adenocarcinoma patients, to provide clinical reference for prognosis prediction and decision-making for patients with lung adenocarcinoma.

Progress in diagnosis of pulmonary ground-glass opacity nodules by radiomic analysis / 中国胸心血管外科临床杂志

@#Differential diagnosis of benign and malignant ground glass nodule (GGN) is of great significance to the early detection, diagnosis and treatment of lung cancer. Increasing attention has been paid to radiomics technology application in early diagnosis of benign and malignant GGN, which can analyze the characteristic appearances of GGN in non-invasive manner. This article reviews the latest research progress of radiomics in the diagnosis of GGN.

Comparison of CT features and pathology in multifocal lung adenocarcinoma with ground glass opacity / 中国医学影像技术

Objective To investigate CT features of multifoeal lung adenocarcinoma (MLA) with ground glass opacity and the relationships with pathology.Methods Totally 16 cases (36 lesions) of MLA confirmed by pathology were collected.Based on pathology,the lesions were divided into pre-invasive lesion group (n =7),minimally invasive adenocarcinoma (MIA) group (n=20) and invasive adenocarcinoma (IAC) group (n =9).CT features of all three groups were analyzed and compared with pathology.Results Among 36 lesions,there were 19 lesions (52.78％) with round shape,19 (52.78％) with lobulation,12 (33.33％) with spiculation sign,13 (36.11％) with vacuole sign,12 (33.33％)with blood vessel cluster sign,and 32 lesions (88.89％) with well-defined interface.Seven pre-invasive lesions (7/7,100％) were all pure ground glass opacity (pGGO),while 12 lesions (12/20,60.00％) were pGGO in MIA group,other 8 lesions (8/20,40.00％) were mixed ground glass opacity (mGGO).Only 1 lesion (1/9,11.11％) in IAC group was pGGO,other 8 lesions (1/9,88.89％) were mGGO.There were significant differences of pGGO,spiculation sign,vacuole sign and blood vessel cluster sign among 3 groups (all P＜0.05).There were significant differences of pGGO,spiculation sign and blood vessel cluster sign between pre-invasive lesion and IAC group (P=0.001,0.003,0.001).Significant differences were found in spiculation sign,vacuole sign and blood vessel cluster sign between MIA and IAC group (P=0.014,0.014,0.001).Conclusion CT findings of multiple ground glass opacity are helpful to diagnosis of MLA before surgery.

Relationship between MSCT image characteristics and pathological subtype in small lung adenocarcinoma with ground-glass opacity / 实用放射学杂志

Objective To analyze the relationship between CT image characteristics and the pathological subtypes of small lung adenocarcinoma (≤3 cm) with ground-glass opacity(GGO).Methods Two hundred and three cases of small lung adenocarcinoma proved by pathology were collected.Use the 2015 World Health Organization(WHO) classification of lung cancers as pathology standard.The relationship between CT findings and pathologic classification were analyzed statistically.Results There was a positive correlation between CT type and pathological type (rs =0.756).The size of atypical adenomatous hyperplasia(AAH),adenocarcinoma in situ(AIS) and minimally invasive adenocarcinoma(MIA) lesions were smaller than invasive adenocarcinoma(IAC).AAH lesions were smaller than MIA(P＜0.008 3).However,there were no significant size differences in AAH and AIS lesions,or in AIS and MIA lesions (P＞0.008 3).The critical point of non-or-little-invasive (AAH,AIS and MIA) and IAC was 15.35 mm (sensitivity 80.8％,specificity 90.4 ％).Differences in lobulation,air bronchogram,vacuole sign,pleural indentation and vascular convergence among pathological types were statistically significant (P ＜0.05).Differences in shape,speculation and cavity among groups were not significant (P ＞0.05).Conclusion The higher CT type,lower GGO content and bigger lesion size are all associated with increasing tumor degree of malignancy.The size of IAC lesion is usually greater than 15.35 mm.Lobulation,air bronchogram,vacuole sign,pleural indentation and vascular convergence can help to diagnose IAC.

A primary study of intraoperative ultrasound location of pulmonary ground-glass opacities in video-assisted thoracic surgery / 中华超声影像学杂志

Objective To evaluate the clinical significance of video-assisted thoracic surgery ( VATS) in localization of pulmonary ground-glass opacities( GGOs) by intraoperative ultrasound ( IU ) . Methods An intraoperative ultrasonographic procedure was prospectively performed on 14 patients harboring GGOs of no more than 3 cm in diameter to localize these lesions and achieve adequate margins . Patients were excluded with both asthma and chronic obstructive pulmonary disease from this study inasmuch as the intraoperative ultrasonographic procedure was more difficult to interpret when residual air is present in the lung . The sonographic characteristics of nodules were compared with those from CT and pathology . Results A total of 18 GGOs were successfully identified by intraoperative ultrasonography without any complications .In all instances 13 GGOs were localized in the lung of complet collapse ,and high-quality echo images were obtained . Additionally ,the IU showed that the nodule sizes were similar to those of CT and postoperative pathological specimens( P < 0 .05) . There was significant difference in lung collapse degree , the maximum diameter of CT and the distance from the lesion to the pleura between echo types ( P <0 .05) . The mean operation time was ( 4 .2 ± 2 .7) min . Conclusions Intraoperative ultrasonography can both safely and effectively localize pulmonary GGO in a completely deflated lung . Hence ,ultrasonography may assist surgeons to perform minimally invasive lung resections with clear surgical margins during the treatment of lung GGO .

The correlation study of ground glass opacity and lepidic growth pattern component in stage I lung invasive adenocarcinoma / 中华肿瘤杂志

Objective@#To investigate the correlation between Ground Glass Opacity (GGO) component proportion and quantitative classification of lepidic growth pattern in pathological stage Ⅰpulmonary adenocarcinoma.@*Methods@#Pathological and HRCT data of 183 stage Ⅰ invasive adenocarcinoma patients from January 2005 to December 2012 were retrospectively reviewed. The proportion of GGO was calculated from diameter and volume.The correlation between GGO component proportion and lepidic growth pattern in pathological were analyzed by Spearman correlation.@*Results@#Among 183 patients, the proportion of GGO component calculated by maximum diameter method and three-dimensional computerized quantification was 0.43±0.35 and 0.20±0.18, respectively. The percentage of lepidic growth pattern component using semi-quantitative analysis of pathological sections was 0.29±0.25.The proportion of GGO by diameter and three-dimensional computerized quantification was significantly correlated with the percentage of lepidic growth pattern component (r=0.599, P< 0.001; r=0.620, P<0.001).@*Conclusions@#There was a positive correlation between the content of lepidic growth pattern and the content of GGO in the small adenocarcinoma. Three-dimensional computerized quantification was a better method in preoperational evaluation.