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CT Predictors of Angiolymphatic Invasion in Non-Small Cell Lung Cancer 30 mm or Smaller

  • 0From the Department of Radiology, Harbin Medical University Cancer Hospital, Harbin, China (Q.S., P.L., J.Z.); and Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029 (Q.S., P.L., R.Y., D.F.Y., C.I.H.).
Radiology +

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January 14, 2025

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January 14, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Radiologic features like the lollipop sign and spiculation, along with volume doubling time (VDT), can predict angiolymphatic invasion (ALI) in early-stage non-small cell lung cancer (NSCLC). These findings aid in assessing ALI risk in solid NSCLCs smaller than 30 mm.

Area Of Science

  • Radiology
  • Oncology
  • Pulmonology

Background

  • Angiolymphatic invasion (ALI) is a critical prognostic factor in non-small cell lung cancer (NSCLC).
  • Predicting ALI using radiologic features in early-stage NSCLCs (≤30 mm) remains underexplored.
  • This study investigates radiologic predictors for ALI in small NSCLCs.

Purpose Of The Study

  • To identify specific radiologic features indicative of angiolymphatic invasion (ALI).
  • To evaluate the predictive value of these features in non-small cell lung cancers (NSCLCs) 30 mm or smaller.
  • To assess the role of volume doubling time (VDT) in predicting ALI.

Main Methods

  • Retrospective review of CT and pathology findings from 778 resected NSCLCs (≤30 mm).
  • Evaluation of radiologic features (e.g., lollipop sign, spiculation), VDT, and PET SUVmax.
  • Multivariable logistic regression and ROC analysis to identify independent predictors of ALI.

Main Results

  • ALI was present in 37.9% of solid NSCLCs, but absent in all 63 subsolid NSCLCs.
  • Lollipop sign (OR=4.12) and spiculation (OR=2.05) were independent predictors of ALI in solid NSCLCs.
  • VDT also predicted ALI (OR=0.96), improving model performance (AUC from 0.77 to 0.82) when combined with other features.

Conclusions

  • In NSCLCs ≤30 mm, ALI is exclusive to solid tumors.
  • Lollipop sign, spiculation, and VDT are significant radiologic predictors of ALI in solid NSCLCs.
  • These imaging findings can help assess ALI risk in early-stage lung cancers.