Related Experiment Video For lung adenocarcinoma
Updated: Mar 31, 2026
Author Spotlight: A 3D Digital Model for the Diagnosis and Treatment of Pulmonary Nodules
Published on: May 19, 2023
Discriminating nodular pulmonary alveolar proteinosis from lung adenocarcinoma with radiomic model and multimodal
Qing Chang1, Huaizhe Zhang2, Ning Xu1
1Department of Pulmonary and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China.
Background:
Pulmonary alveolar proteinosis (PAP) typically manifests as diffuse lung disease, while nodular PAP presenting as pulmonary nodules is extremely rare and often radiologically indistinguishable from early-stage lung adenocarcinoma (LUAD).
Objectives:
This study aims to establish an accurate diagnostic algorithm to prevent unnecessary invasive procedures in patients with nodular PAP.
Design:
This study was a retrospective, single-center study.
Methods:
This study enrolled 16 pathologically confirmed nodular PAP patients and 52 early-stage LUAD patients, systematically comparing their clinical characteristics and biochemical markers. A radiomics model was developed based on CT imaging features, followed by a multimodal model incorporating significant clinical and biochemical discriminators.
Results:
The nodular PAP cohort demonstrated a 3:5 male-to-female ratio, equivalent distribution of solitary versus multiple nodules, and nodule diameters spanning 3-28 mm. Nodular PAP patients were significantly younger (mean 51.4 vs 67.0 years, p < 0.001), had higher body mass index (BMI, 25.8 ± 2.5 vs 23.7 ± 2.8 kg/m², p < 0.01), and lower lactate dehydrogenase levels (LDH, 188.44 ± 26.71 vs 214.79 ± 56.84 U/L, p = 0.01) compared to LUAD patients. The radiomic model achieved an AUC (area under the curve) of 0.91, while the multimodal model combining clinical and biochemical features showed similar performance (AUC = 0.97).
Conclusion:
This study provides the characterization of nodular PAP and establishes radiomic and multimodal diagnostic models with similar accuracy, which are reliable tools to make a differential diagnosis between nodular PAP and LUAD and to prevent unnecessary surgery.
