[HRCT features differentiate synchronous multiple primary lung adenocarcinomas from intrapulmonary metastases]

Area of Science:

• Radiology
• Oncology
• Pulmonology

Background:

• Differentiating synchronous multiple lung adenocarcinoma from intrapulmonary metastasis is crucial for treatment planning.
• High-resolution CT (HRCT) is a key imaging modality for lung nodule characterization.

Purpose of the Study:

• To investigate HRCT features for differentiating synchronous multiple lung adenocarcinoma from lung adenocarcinoma with intrapulmonary metastasis.
• To identify imaging characteristics that distinguish primary lesions from metastatic lesions.

Main Methods:

• Retrospective analysis of HRCT features in 131 lesions from 62 patients with synchronous multiple primary lung adenocarcinoma and 67 lesions from 31 patients with lung adenocarcinoma intrapulmonary metastases.
• Classification of lesions into pure ground glass nodule (pGGN), mixed ground glass nodule (mGGN), and solid nodule (SN).
• Comparison of imaging features including size, ground glass components, shape, margin, and pleural attachment between the two groups.

Main Results:

• Synchronous primary lung adenocarcinoma predominantly featured pGGN and mGGN, with at least one lesion containing ground glass components in 96.8% of cases.
• Lung adenocarcinoma with intrapulmonary metastases frequently presented as SN+SN (93.5%) or mGGN+SN (6.5%).
• Significant differences were observed in lesion types (P<0.01), with male gender, SN, and pleural attachment identified as risk factors for metastasis (P<0.05).

Conclusions:

• HRCT features can effectively differentiate synchronous multiple lung adenocarcinoma from lung adenocarcinoma with intrapulmonary metastasis.
• Presence of ground glass components (pGGN or mGGN) suggests synchronous primaries, whereas solid nodules (SN) are more indicative of metastasis.
• Consider intrapulmonary metastasis when the main lesion is an SN with pleural attachment and accompanying lesions are also solid nodules.