Nodular ground-glass opacity at thin-section CT: histologic correlation and evaluation of change at follow-up
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TLDR
An awareness of the clinical setting, in addition to familiarity with the thin-section CT features of nodular ground-glass opacity at initial and follow-up imaging over several months, can help identify malignancy and achieve an accurate diagnosis.Abstract:
The popularization of computed tomography (CT) in clinical practice and the introduction of mass screening for early lung cancer with the use of CT have increased the frequency of findings of subtle nodules or nodular ground-glass opacity. Nodular ground-glass opacity may be observed in malignancies such as bronchioloalveolar carcinoma and adenocarcinoma, as well as in their putative precursors, such as atypical adenomatous hyperplasia. Nodular ground-glass opacity also may be seen in the presence of benign conditions, including focal interstitial fibrosis, inflammation, and hemorrhage. The persistence of nodular ground-glass opacity over time may be strongly suggestive of an early-stage malignancy, especially if the lesion increases in size or includes a solid component that increases in its extent. Persistent nodular ground-glass opacity also may remain stable in size but show increased attenuation. The more extensive the solid portions of the lesion, the higher the probability of malignancy and the poorer the prognosis. An awareness of the clinical setting, in addition to familiarity with the thin-section CT features of nodular ground-glass opacity at initial and follow-up imaging over several months, can help identify malignancy and achieve an accurate diagnosis. A meticulous evaluation of those CT features, and their correlation with specific histopathologic characteristics, also may enable a more accurate prognosis in cases of neoplastic disease.read more
Citations
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Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017
Heber MacMahon,David P. Naidich,Jin Mo Goo,Kyung Soo Lee,Ann N. Leung,John R. Mayo,Atul C. Mehta,Yoshiharu Ohno,Charles A. Powell,Mathias Prokop,Geoffrey D. Rubin,Cornelia M. Schaefer-Prokop,William D. Travis,Paul Van Schil,Alexander A. Bankier +14 more
TL;DR: These guidelines represent the consensus of the Fleischner Society, and as such, they incorporate the opinions of a multidisciplinary international group of thoracic radiologists, pulmonologists, surgeons, pathologists, and other specialists.
Journal ArticleDOI
Recommendations for the Management of Subsolid Pulmonary Nodules Detected at CT: A Statement from the Fleischner Society
David P. Naidich,Alexander A. Bankier,Heber MacMahon,Cornelia M. Schaefer-Prokop,Massimo Pistolesi,Jin Mo Goo,Paolo Macchiarini,James D. Crapo,Christian J. Herold,John H. M. Austin,William D. Travis +10 more
TL;DR: In this article, the authors proposed a set of recommendations specifically aimed at subsolid nodules, which are based on the original Fleischner Society guidelines for incidentally detected solid nodules.
Journal ArticleDOI
The IASLC Lung Cancer Staging Project: Proposals for Coding T Categories for Subsolid Nodules and Assessment of Tumor Size in Part-Solid Tumors in the Forthcoming Eighth Edition of the TNM Classification of Lung Cancer
William D. Travis,Hisao Asamura,Alexander A. Bankier,Mary Beth Beasley,Frank C. Detterbeck,Douglas B. Flieder,Jin Mo Goo,Heber MacMahon,David P. Naidich,Andrew G. Nicholson,Charles A. Powell,Mathias Prokop,Ramón Rami-Porta,Valerie W. Rusch,Paul Van Schil,Yasushi Yatabe,Peter Goldstraw,David Ball,David G. Beer,Ricardo Beyruti,Vanessa Bolejack,Kari Chansky,John Crowley,Wilfried Eberhardt,John G. Edwards,Françoise Galateau-Salle,Dorothy Giroux,Fergus V. Gleeson,Patti A. Groome,James Huang,Catherine Kennedy,Jhingook Kim,Young Tae Kim,Laura Kingsbury,Haruhiko Kondo,Mark Krasnik,Kaoru Kubota,Antoon Lerut,Gustavo Lyons,Mirella Marino,Edith M. Marom,Jan P. van Meerbeeck,Alan Mitchell,Takashi Nakano,Anna K. Nowak,Michael D Peake,Thomas W. Rice,Kenneth E. Rosenzweig,Enrico Ruffini,Nagahiro Saijo,Jean-Paul Sculier,Lynn Shemanski,Kelly G. Stratton,Kenji Suzuki,Yuji Tachimori,Charles F. Thomas,William D. Travis,Ming-Sound Tsao,Andrew T. Turrisi,Johan Vansteenkiste,Hirokazu Watanabe,Yi-Long Wu,Paul Baas,Jeremy J. Erasmus,Seiki Hasegawa,Kouki Inai,Kemp H. Kernstine,Hedy L. Kindler,Lee M. Krug,Kristiaan Nackaerts,Harvey I. Pass,David C. Rice,Conrad Falkson,Pier Luigi Filosso,Giuseppe Giaccone,Kazuya Kondo,Marco Lucchi,Meinoshin Okumura,Eugene H. Blackstone +78 more
TL;DR: Codes for the primary tumor categories of AIS and minimally invasive adenocarcinoma (MIA) and a uniform way to measure tumor size in part‐solid tumors for the eighth edition of the tumor, node, and metastasis classification of lung cancer are proposed.
Journal ArticleDOI
Invasive pulmonary adenocarcinomas versus preinvasive lesions appearing as ground-glass nodules: differentiation by using CT features.
TL;DR: In pure GGNs, a lesion size of less than 10 mm can be a very specific discriminator of preinvasive lesions from IPAs, and in part-solid G GNs, prein invasive lesions can be accurately distinguished from IPA by the smaller lesion sizes, smaller solid proportion, nonlobulated border, and nonspiculated margin.
Journal ArticleDOI
Computerized Texture Analysis of Persistent Part-Solid Ground-Glass Nodules: Differentiation of Preinvasive Lesions from Invasive Pulmonary Adenocarcinomas
TL;DR: In part-solid GGNs, higher kurtosis and smaller mass are significant differentiators of preinvasive lesions from IPAs, and prein invasive lesions can be accurately differentiated from IPs by using computerized texture analysis.
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