Clinical significance of a solitary ground-glass opacity (GGO) lesion of the lung detected by chest CT

Oh, Jin Young; Kwon, Sung Youn; Yoon, Ho Il; Lee, Sang Min; Yim, Jae Joon; Lee, Jae Ho; Yoo, Chul Gyu; Kim, Young Whan; Han, Sung Koo; Shim, Young Soo; Kim, Tae Jung; Lee, Kyungwon; Chung, Jin Haeng; Jheon, Sang Hoon; Sung, Sook Whan; Lee, Choon Taek

doi:10.1016/j.lungcan.2006.09.009

Cited by 127 publications

(112 citation statements)

References 25 publications

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“…An SSN can be a part-solid GGN ( part of the nodule completely obscures the underlying lung parenchyma) or a pure GGN (no completely obscured areas, hence pure ground glass) [3]. While transient SSNs can represent a large range of benign diseases, persistent SSNs have a high likelihood of malignancy, with reported malignancy rates ranging from 19.4% to 75% [4,5]. These malignancy rates are much higher than the likelihood of malignancy of solid pulmonary nodules: the Early Lung Cancer Action Project (ELCAP) study reported a malignancy rate among their positive findings of 34% for pure GGNs and 63% for part-solid GGNs, while only 7% of the solid nodules were malignant [1].…”

Section: Introductionmentioning

confidence: 99%

Towards a close computed tomography monitoring approach for screen detected subsolid pulmonary nodules?

et al. 2014

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Pulmonary subsolid nodules (SSNs) have a high likelihood of malignancy, but are often indolent. A conservative treatment approach may therefore be suitable. The aim of the current study was to evaluate whether close follow-up of SSNs with computed tomography may be a safe approach.The study population consisted of participants of the Dutch-Belgian lung cancer screening trial (Nederlands Leuvens Longkanker Screenings Onderzoek; NELSON). All SSNs detected during the trial were included in this analysis. Retrospectively, all persistent SSNs and SSNs that were resected after first detection were segmented using dedicated software, and maximum diameter, volume and mass were measured. Mass doubling time (MDT) was calculated.In total 7135 volunteers were included in the current analysis. 264 (3.3%) SSNs in 234 participants were detected during the trial. 147 (63%) of these SSNs in 126 participants disappeared at follow-up, leaving 117 persistent or directly resected SSNs in 108 (1.5%) participants available for analysis. The median follow-up time was 95 months (range 20-110 months). 33 (28%) SSNs were resected and 28 of those were ( pre-) invasive. None of the non-resected SSNs progressed into a clinically relevant malignancy.Persistent SSNs rarely developed into clinically manifest malignancies unexpectedly. Close follow-up with computed tomography may be a safe option to monitor changes. @ERSpublications Persistent subsolid pulmonary nodules may be safely monitored with follow-up computed tomography

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Section: Introductionmentioning

confidence: 99%

Towards a close computed tomography monitoring approach for screen detected subsolid pulmonary nodules?

et al. 2014

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“…mixed GGOs). KIM et al [10] found the malignancy rate for persistent GGOs to be 75%, whereas other Japanese or Korean groups observed malignancy rates in the range of 19-38%, perhaps due to different study populations [14,16,17].…”

Section: Pulmonary Ground-glass Opacities M Infante Et Almentioning

confidence: 96%

“…Pre-operative percutaneous hook-wire marking is always carried out in the current authors' centre (Istituto Clinico Humanitas Hospital) when a limited resection is planned, as focal GGOs may not be palpable at all [16].…”

Section: Pulmonary Ground-glass Opacities M Infante Et Almentioning

confidence: 99%

Differential diagnosis and management of focal ground-glass opacities

Infante¹,

Lutman²,

Imparato³

et al. 2008

Eur Respir J

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Focal pulmonary ground-glass opacities (GGOs) can be associated with bronchioloalveolar carcinoma. The present retrospective study aimed to test the validity of a multistep approach to discriminate malignant from benign localised (focal) GGOs, identifies useful diagnostic features on computed tomography (CT), and suggests appropriate management guidelines.A stepwise approach, including oral antibiotics, follow-up high-resolution CT (HRCT) 40-60 days later and CT-guided core biopsy, was used. All cases with localised GGOs detected since 2001 were reviewed. CT features were described according to a structured scheme. In total, 40 patients were evaluated. Of these, 11 patients were diagnosed with benign GGOs, 19 patients had lung cancer and 10 were undetermined.Nonpolygonal shape, apparent radial growth and clear-cut margins were associated with a malignant histology. The specificity of CT findings was low. Diagnostic accuracy increased after oral antibiotics, follow-up HRCT and percutaneous core biopsy. Overall, 18 patients underwent surgery for lung cancer.In conclusion, malignant ground-glass opacities have a fairly typical appearance, but some benign lesions closely mimic their malignant counterparts. The stepwise approach adopted in the present study increased the diagnostic specificity and reduced time to definitive diagnosis. Segmentectomy might be the ideal resection volume for such tumours.

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“…The observation discriminates transient GGO from persistent GGO. Transient GGO is one that disappears during follow up (19,20). The optimal follow-up time is two or three months.…”

Section: Management Of Ggomentioning

confidence: 99%

Whack-a-mole strategy for multifocal ground glass opacities of the lung

Suzuki¹

2017

J. Thorac. Dis.

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Ground glass opacity (GGO) is a good prognostic indicator for lung cancer and is useful for physicians to predict prognosis. Due to recent advances in computed tomography (CT), the chance to encounter GGO is rapidly increasing in clinical practice. Based on the studies on radiological pathological correlation, GGO represents pathological lepidic growth and consolidation on CT represents pathologically invasive components. Thus, consolidation tumor ratio 0.5 or less means pathological less invasiveness for lung cancer. Not a few studies have shown that sublobar resection is equivalent to lobectomy for radiological early lung cancers. Additionally, observation of GGO is one of the options for physicians. Indication of surgical intervention remains unclear. Physician observing GGO in practice should know the natural history of GGO to reach an optimal treatment decision. For multifocal GGO lesions clinical management is surely challenging. Whack-a-mole strategy, which means sublobar resection for radiological invasive cancer is one of the most promising strategies for such lesions.

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Clinical significance of a solitary ground-glass opacity (GGO) lesion of the lung detected by chest CT

Cited by 127 publications

References 25 publications

Towards a close computed tomography monitoring approach for screen detected subsolid pulmonary nodules?

Towards a close computed tomography monitoring approach for screen detected subsolid pulmonary nodules?

Differential diagnosis and management of focal ground-glass opacities

Whack-a-mole strategy for multifocal ground glass opacities of the lung

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