Predicting pleural invasion using HRCT and 18F-FDG PET/CT in lung adenocarcinoma with pleural contact

Tanaka, Takashi; Shinya, Takayoshi; Sato, Shuhei; Mitsuhashi, Toshiharu; Ichimura, Koichi; Soh, Junichi; Toyooka, Shinichi; Kaji, Masahide; Miyoshi, Shinichiro; Kanazawa, Susumu

doi:10.1007/s12149-015-0999-x

Cited by 26 publications

(35 citation statements)

References 22 publications

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“…The length of contact with pleura was significantly greater in tumors with pleural invasion than in those without pleural invasion. [ 7 , 13 ] Our study found that pleural contact >3 cm was not significantly associated with pleural invasion. A possible explanation for the discrepant results is that some of our cases might have been contaminated with pneumonia or atelectasis.…”

Section: Discussionmentioning

confidence: 58%

“…In contrast, Ebara et al [ 7 ] reported that blunt angle and pleural thickening were not significantly associated with pleural invasion on 1-mm thickness CT imaging. Tanaka et al [ 13 ] found that blunt angle was associated with pleural invasion and pleural thickening but was not significantly associated with pleural invasion on 1- to 3-mm thickness CT imaging. Blunt angle and pleural thickening were not significantly associated with pleural invasion in our study, which is consistent with Ebara et al [ 7 ] A possible explanation for these discordant results is differences in patient characteristics and CT parameters.…”

Section: Discussionmentioning

confidence: 99%

“…Tumor size was significantly larger in the presence of pleural invasion than in the absence of pleural invasion, which is consistent with the literature. [ 7 , 13 ] Tumor border type 5 had none to slight agreement with blunt angle, pleural contact >3 cm, and pleural thickening. Therefore, tumor border type 5 could be a distinctive indicator of pleural invasion by peripheral NSCLC.…”

Section: Discussionmentioning

confidence: 99%

“…Ebara et al [ 7 ] further reported that the ratio of the tumor-pleura interfacial area to tumor size could differentiate between parietal and visceral pleural invasion with 77% accuracy. Tanaka et al [ 13 ] used SUV max 4.3 on 18 F-FDG PET/CT as the cutoff value for predicting visceral pleural invasion with 85% accuracy. Other suggested methods for differentiating between parietal and visceral pleural invasion include, respiratory dynamic MR imaging, ultrasonography, and CT combined with artificial pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

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Convex border of peripheral non-small cell lung cancer on CT images as a potential indicator of pleural invasion

et al. 2017

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The aim of the study is to evaluate the use of the tumor border in peripheral non-small cell lung cancer (NSCLC) as an indicator of pleural invasion.This retrospective study was performed at a single tertiary center. The analysis of 136 patients with peripheral NSCLC included 101 (74.3%) patients with pathologically proven pleural invasion and 35 (25.7%) patients without pleural invasion. The tumor borders on conventional computed tomography (CT) were classified into 5 types on lung window setting: type 1, S or reverse S border with a blunt angle; type 2, sharp angle; type 3, concave border with a blunt angle; type 4, straight border with a perpendicular angle; and type 5, convex border with a perpendicular or blunt angle. In patients with more than 1 tumor border type, the priority was type 5, 4, 3, 2, and 1. Blunt angle, pleural contact >3 cm, and adjacent pleural thickening were also recorded for comparison with pleural invasion of peripheral tumors.Tumor border types 2 and 5 significantly differed between patients with and without pleural invasion (P = .001 and P < .001, respectively). Patients with and without pleural invasion did not significantly differ in tumor border type 1, tumor border type 3, tumor border type 4, blunt angle, pleural contact >3 cm, or pleural thickening. Tumor border type 5 was a moderate indicator of pleural invasion with positive LR, 5.20; accuracy, 57%; sensitivity, 45%; specificity, 91%; PPV, 94%; and NPV, 36%. Tumor border type 2 was a weak indicator of pleural invasion with positive LR, 0.51; accuracy, 34%; sensitivity, 34%; specificity, 34%; PPV, 60%; and NPV, 15%.Tumor border type 5 has a high PPV and high specificity for predicting pleural invasion by peripheral NSCLC.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Convex border of peripheral non-small cell lung cancer on CT images as a potential indicator of pleural invasion

et al. 2017

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“…In a prospective clinical trial, it was shown that preoperative PET/CT for staging of NSCLC reduced both total thoracotomies and futile thoracotomies [22]. In another retrospective clinical study, high-resolution computed tomog-raphy (HRCT) findings and fluorine-18-fluorodeoxyglucose ((18) F-FDG) uptake have been employed for risk stratification of visceral pleural invasion by lung adenocarcinoma [23].…”

Section: Discussionmentioning

confidence: 99%

Prediction of Pleural Invasion in Challenging Non-Small-Cell Lung Cancer Patients Using Serum and Imaging Markers

Zhu

Chen

et al. 2020

Disease Markers

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Introduction. Preoperative detection of pleural invasion in lung cancer patients is key to curative surgical treatment. We tried to predict pleural invasion in non-small-cell lung cancer patients with <100 ml pleural fluid. Methods. Patients admitted from August 1, 2011, to December 31, 2018, were retrospectively retrieved. Records of serum and imaging markers were analyzed. Results. Among 7004 patients who received surgery, 43 cases with <100 ml pleural fluid who had pleural invasion were included, and another 108 cases without pleural invasion were enrolled as controls. There were no differences in squamous cell carcinoma antigen (SCC) or neuron-specific enolase (NSE) values between the pleural invasion and noninvasion groups (p = 0:30 and 0.14, respectively), but there were significant differences in carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA21-1) values (p < 0:01 and 0.01, respectively). There were significant differences in the location of original lung cancer (right mid lobe, p = 0:01), maximum lung lesion diameter (p < 0:01), volume of pleural fluid (nondetectable vs. detectable fluid, p < 0:01), pleural sign (p = 0:03), and positron emission tomography/computed tomography-(PET/CT-) predicted pleural invasion (p = 0:02) between the pleural invasion and noninvasion groups. The maximum Area-Under-the-Curve in the Receiver Operating Characteristic curve analysis was achieved with the combination of CEA, CYFRA21-1, detectable pleural fluid, PET/CT prediction, pleural sign, and location of the lung lesion. Conclusions. Serum CEA and CYFRA21-1, location of original lung cancer (right mid lobe), maximum diameter, CT-detectable pleural fluid, pleural sign by CT, and PET/CT-predicted pleural invasion were good markers for the prediction of pleural invasion in non-small-cell lung cancer patients.

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Predictive Value of¹⁸F‐FDG PET/MRIfor Pleural Invasion in Solid and Subsolid Lung Adenocarcinomas Smaller Than 3 cm

Zhang

Meng

Yao

et al. 2022

Magnetic Resonance Imaging

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BackgroundPositron emission tomography (PET)/MRI combines the characteristics of metabolism imaging and high soft tissue resolution, and could provide high diagnostic efficacy for assessment of pleural invasion (PI) of lung cancer.PurposeTo investigate the application of 18F‐fluorodeoxyglucose (FDG) PET/MRI for predicting PI of lung cancer with the maximum diameter ≤3 cm.Study TypeProspective.PopulationA total of 44 patients with non‐small cell lung cancer (NSCLC), age from 39 to 79 years old, including 19 (56.82%) females.Field Strength/SequenceA 3‐T, hybrid PET/MRI including axial fast spin echo respiratory‐triggered T2 fat‐suppressed imaging (T2FS) and echo planar imaging diffusion‐weighted imaging (DWI).AssessmentThe maximum standardized uptake value (SUVmax) of all lesions was measured on PET images. Localized effusion outside the contact between the nodules and the pleura on T2FS and signal at the contact between the nodules and the pleura on DWI were evaluated by experienced physicians through visual assessment of the MRI sequences.Statistical TestsThree models (models 1–3) were developed, incorporating CT, CT and PET, PET and MRI features, and Lasso regression was used in feature selection. The receiver operating characteristic (ROC) curve for PI diagnosis was visualized for each model, and the area under the curve (AUC) was calculated. The DeLong test was used to compare the different AUCs. A P value < 0.05 was considered statistically significant.ResultsThe AUC of models 1–3 was 0.762, 0.829, and 0.915, respectively. The DeLong test showed a statistically significant difference between the AUCs of model 1 vs. model 3, while the differences between the AUCs of model 1 vs. model 2 (P = 0.253) and model 2 vs. model 3 (P = 0.075) were not statistically significant.Data conclusion18F‐FDG PET/MRI might show high predictive value for lung adenocarcinoma smaller than 3 cm with PI.Evidence Level1Technical EfficacyStage 2

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Predicting pleural invasion using HRCT and 18F-FDG PET/CT in lung adenocarcinoma with pleural contact

Cited by 26 publications

References 22 publications

Convex border of peripheral non-small cell lung cancer on CT images as a potential indicator of pleural invasion

Convex border of peripheral non-small cell lung cancer on CT images as a potential indicator of pleural invasion

Prediction of Pleural Invasion in Challenging Non-Small-Cell Lung Cancer Patients Using Serum and Imaging Markers

Predictive Value of¹⁸F‐FDG PET/MRIfor Pleural Invasion in Solid and Subsolid Lung Adenocarcinomas Smaller Than 3 cm

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Predicting pleural invasion using HRCT and 18F-FDG PET/CT in lung adenocarcinoma with pleural contact

Cited by 26 publications

References 22 publications

Convex border of peripheral non-small cell lung cancer on CT images as a potential indicator of pleural invasion

Convex border of peripheral non-small cell lung cancer on CT images as a potential indicator of pleural invasion

Prediction of Pleural Invasion in Challenging Non-Small-Cell Lung Cancer Patients Using Serum and Imaging Markers

Predictive Value of18F‐FDG PET/MRIfor Pleural Invasion in Solid and Subsolid Lung Adenocarcinomas Smaller Than 3 cm

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Predictive Value of¹⁸F‐FDG PET/MRIfor Pleural Invasion in Solid and Subsolid Lung Adenocarcinomas Smaller Than 3 cm