Volume Doubling Times of Lung Adenocarcinomas: Correlation with Predominant Histologic Subtypes and Prognosis

Abstract

THORACIC IMAGING L ung adenocarcinoma is known for its pathologic heterogeneity and variable prognosis. To improve the classification of lung adenocarcinomas, the 2015 World Health Organization classification of lung tumors recommended classification of resected lung adenocarcinoma according to the most predominant histologic subtype (1). Many studies that followed confirmed that this classification provides prognostic stratification (2-7): Lepidic-predominant subtypes have a good prognosis, acinar and papillary predominant subtypes have an intermediate prognosis, and micropapillary and solid predominant subtypes have a poor prognosis.Interestingly, although CT features may overlap across the different predominant histologic subtypes, lepidicpredominant adenocarcinoma is more likely to manifest as pure and part-solid ground-glass opacity, whereas solid-predominant adenocarcinomas are likely to show a lower ground-glass opacity proportion (8,9). Given that lung cancers manifesting as subsolid nodules have a longer volume doubling time (VDT) than those manifesting as solid nodules (10-13), it is possible that VDTs vary according to the predominant histologic subtypes with implications for prognosis.The VDT of tumors, which theoretically reflects the exponential growth of tumor cells, is a key parameter for the differentiation of aggressive tumors from slowgrowing tumors and aids in predicting the likelihood of malignancy in pulmonary lesions. In the Dutch-Belgian randomized lung cancer screening trial, known as the NELSON study, a follow-up process on the basis of VDT (,400, 400-600, and .600 days) was effective in terms of reducing the false-positive rate (14). Henschke et al (10) demonstrated that the VDT of lung cancer varies according to the lung cancer subtypes and

Prediction of the Growth Rate of Early-Stage Lung Adenocarcinoma by Radiomics

“…Radiomics can reveal a large amount of invisible, highdimensional information with potential clinical value hidden behind the image. Currently, radiomics has achieved good results in the diagnosis of benign and malignant pulmonary nodules (14,15). However, there are few radiomics methods for the prediction of the growth rate of pulmonary nodules.…”

Lung cancer classification based on CT scan image by applying FCM segmentation and neural network technique

“…Stage I, II, and III can be predicted by an axial CT scan of the lungs. While Stage IV patients can feel the symptoms because the cancer has spread throughout the body and cannot be identified from the CT scan [9]. Stage I lung cancer is said to be benign because it does not kill the patient.…”

Lung Adenocarcinomas: Can Volume Doubling Time Aid Management?

“…Park and colleagues (6) showed that VDTs of partsolid lesions did not differ across histologic subtypes, unlike solid tumor VDTs. Their solid or micropapillary study sample, considered high-grade tumors, had VDTs of 164 days, indicating more aggressive high-grade tumors and supporting the clinical significance of solid components within part-solid nodules.…”

“…In this issue of Radiology, Park et al (6) reported on VDTs in 268 patients with confirmed lung adenocarcinoma subtypes, as categorized by using the 2011 International Association for the Study of Lung Cancer (IASLC), classification. This classification addresses surgical pathologic structure and small biopsy specimen diagnosis (1,6) and is now incorporated into the World Health Organization Classification of Lung Cancer.…”

“…In this issue of Radiology, Park et al (6) reported on VDTs in 268 patients with confirmed lung adenocarcinoma subtypes, as categorized by using the 2011 International Association for the Study of Lung Cancer (IASLC), classification. This classification addresses surgical pathologic structure and small biopsy specimen diagnosis (1,6) and is now incorporated into the World Health Organization Classification of Lung Cancer. IASLC lung adenocarcinoma spectrum lesions include preinvasive entities of atypical adenomatous hyperplasia and adenocarcinoma in situ, which contain lepidic noninvasive growth, are 5 mm or 3 cm or smaller, and manifest as nonsolid (also termed pure ground-glass nodules) on chest CT images.…”