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Solid-type adenocarcinoma on thin-section CT: quantitative parameters from dual-energy CT associated with spread
Junli Tao1, Hanshan Xu1, Lili Shen2
1Department of Radiology, Chongqing University Cancer Hospital, Chongqing, PR China.
Acta Radiologica (Stockholm, Sweden : 1987)
|December 27, 2024
Summary
Spread Through Air Spaces (STAS) in lung adenocarcinoma is linked to lower iodine uptake. Low iodine concentration (ICA) and normalized arterial phase iodine concentration (NICA) predict STAS-positive status and poorer outcomes.
Area of Science:
- Radiology
- Oncology
- Pulmonary Medicine
Background:
- Spread Through Air Spaces (STAS) is a known predictor of poor oncological outcomes in lung adenocarcinoma surgery.
- A potential disparity in iodine uptake exists between STAS-positive and STAS-negative patients.
Purpose of the Study:
- To investigate the association between iodine uptake and STAS status in patients with solid lung adenocarcinoma.
- To identify correlations between iodine concentration and STAS in resected lung adenocarcinomas.
Main Methods:
- Retrospective analysis of 52 patients who underwent lung adenocarcinoma resection (Jan-June 2022).
- Iodine concentration and CT features assessed via contrast-enhanced dual-energy CT (DECT).
- Comparison of DECT findings with STAS status.
Main Results:
- STAS-positive status (48% of patients) was significantly associated with lower arterial phase iodine concentration (ICA), normalized arterial phase iodine concentration (NICA), and venous phase iodine concentration (ICV).
- Specific cutoffs for ICA (1.15 mg/mL), NICA (0.11), and ICV (1.35 mg/mL) were identified.
- ICA and NICA demonstrated high predictive value (AUCs 0.82 and 0.83, respectively) and were independent risk factors for STAS.
Conclusions:
- Low ICA, NICA, and ICV are associated with STAS-positive solid lung adenocarcinoma.
- These findings suggest a link between reduced iodine uptake, STAS, and potentially worse survival outcomes in lung adenocarcinoma patients.
