Dual-layer spectral detector CT (SDCT) can improve the detection of mixed ground-glass lung nodules

Abstract

Background Mixed ground-glass lung nodules are a high-risk factor for lung adenocarcinoma. This study aimed to analyze the value of SDCT electron density imaging in the detection of mixed ground-glass lung nodules (GGNs). Method 150 patients with GGNs confirmed by chest SDCT and surgical pathology were retrospectively analyzed. GGNs were screened by two senior radiologists by the double-blind method based on conventional CT and SDCT electron density images. Average CT values and electron density (ED) values of GGNs were measured for all, solid and ground-glass. Result Thirty pGGN cases determined by conventional CT were found to be mGGN on electron density images, including 23 in the invasive adenocarcinoma group (detection rate of 35.38%), which was significantly higher than that of the PGL group (14.89%, P < 0.05). In electron density images, average CT values and ED values in the PGL and invasive adenocarcinoma groups with pGGNs were no difference. The average CT value and ED value were significantly higher in the mGGN invasive adenocarcinoma group compared with the PGL group ( P < 0.05). Meanwhile, ROC curve analysis of average CT value and ED value revealed AUC values for mGGN infiltration of 0.759 and 0.752. Conclusion SDCT can improve GGN visualization and increase the detection rate of mGGN compared with conventional CT. Attention should be paid to invasive adenocarcinoma for lung GGNs detected as mGGNs with high average CT value or ED value.

Spectral Dual-Layer Computed Tomography Can Predict the Invasiveness of Ground-Glass Nodules: A Diagnostic Model Combined with Thymidine Kinase-1

“…Additionally, EDW (a) also had a high diagnostic performance (AUC = 0.838), was an independent predictor of GGN aggressiveness, and positively correlated with the degree of invasion, which conformed to Zhang et al's results [14]. There are currently few examples of research on Zeff and EDW for predicting GGN.…”

“…Further, EDW shows a relative distribution plot of electron density corresponding to each voxel without requiring conversion to CT values, and the results are more accurate [16]. The advancement of PGL-MIA-IAC was accompanied by increased numbers of deteriorating tumor cells, resulting in the thickening of the alveolar cavity, the collapse of the alveoli, and decreased intraluminal gas, with the appearance of elevated EDW [14].…”

Predictive value of spectral dual-detector computed tomography for PD-L1 expression in stage I lung adenocarcinoma: Development and validation of a nomogram

“…25 ED displays the relative distribution of the electron density corresponding to each voxel ratio to water, without the need for CT value conversion. Using this method, the lesion area can be accurately displayed with higher sensitivity than traditional CT. 26 Zhang et al 27 proposed that ED can detect more mGGOs and display their in ltrating components, providing a new method for the pre-operative pathological classi cation of GGO. Prior research on Zeff and ED has mostly concentrated on identifying benign and malignant pulmonary nodules and their pathological or histological subtypes 13,[27][28] ; however, tumor gene/receptor expression has received less attention.…”