Comparison between solid component size on thin-section CT and pathologic lymph node metastasis and local invasion in...

Area of Science:

• Radiology
• Oncology
• Pulmonology

Background:

• T1 lung adenocarcinoma staging is crucial for treatment planning.
• Accurate prediction of lymph node (LN) metastasis and local invasion (LI) impacts patient management.
• Thin-section CT (TS-CT) is a key imaging modality for lung nodule assessment.

Purpose of the Study:

• To correlate tumor and solid component size on TS-CT with pathological LN metastasis and LI in T1 lung adenocarcinoma.
• To evaluate the predictive value of solid component dimensions for negative LN metastasis and LI.

Main Methods:

• Retrospective analysis of 188 surgically resected T1 lung adenocarcinoma cases.
• Measurement of tumor and solid component dimensions by two radiologists using TS-CT with lung and mediastinal window settings.
• Correlation of average long-axis dimensions with pathological findings, including interobserver agreement.

Main Results:

• Only 3.7% of patients had pathological LN-positive metastasis.
• A solid component long axis <5 mm (mediastinal window) or <8 mm (lung window) on TS-CT predicted a 100% negative predictive value for LN metastasis.
• Positive predictive values for pathological local invasion (LI)-negative status were 91% and 90% with mediastinal and lung window settings, respectively.

Conclusions:

• Solid component size on TS-CT is a potential predictor of lymph node-negative status in T1 lung adenocarcinoma.
• TS-CT measurements of solid component size may help predict the absence of local invasion, aiding in treatment decisions.