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CT feature-based nomogram for predicting tumor spread through air spaces in stage IA lung adenocarcinoma.

Bin Luo¹, Han Yang¹, Ningbo Fan¹

¹Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510000, PR China.

Cancer Imaging : the Official Publication of the International Cancer Imaging Society

|June 11, 2025

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This study identifies key predictors of Spread Through Air Spaces (STAS) in early-stage lung adenocarcinoma. A developed nomogram accurately predicts STAS, aiding surgical decisions for lung cancer patients.

Area of Science:

Oncology
Thoracic Surgery
Radiology

Background:

Spread Through Air Spaces (STAS) is a pattern of tumor spread in lung adenocarcinoma (LUAD).
Predicting STAS preoperatively is crucial for surgical planning in stage IA LUAD.

Purpose of the Study:

To investigate clinicopathological and CT imaging factors associated with STAS in stage IA LUAD.
To develop and validate a predictive model for STAS before surgery.

Main Methods:

Analysis of 1,375 stage IA LUAD patients.
Propensity score matching (PSM) for STAS-positive and negative groups.
Logistic regression and nomogram development, validated with ROC and DCA.

Main Results:

Keywords:

CT features Clinicopathologic features Lung adenocarcinoma Nomogram Spread through air spaces

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Independent risk factors for STAS included irregular nodule shape, irregular margin, lobulation, and vascular convergence.

Higher consolidation tumor ratio (CTR) significantly increased STAS risk.

The nomogram demonstrated good predictive accuracy (AUC=0.812) and clinical utility.

Conclusions:

A preoperative nomogram effectively predicts STAS in stage IA LUAD.
This tool can assist surgeons in making informed decisions regarding surgical extent.