HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Masaki Anraku Kohei Yokoi Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Matsuguma, H. Articles by Yokoi, K. Search for Related Content PubMed PubMed Citation Articles by Matsuguma, H. Articles by Yokoi, K. Related Collections Lung - cancer Minimally invasive surgery

Eur J Cardiothorac Surg 2004;25:1102-1106
© 2004 Elsevier Science NL

Objective definition and measurement method of ground-glass opacity for planning limited resection in patients with clinical stage IA adenocarcinoma of the lung

^a Division of Thoracic Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi 320-083, Japan
^b Division of Thoracic Diseases, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi 320-0834, Japan
^c Division of Pathology, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi 320-0834, Japan

Received 16 September 2003; received in revised form 17 January 2004; accepted 4 February 2004.

^* Corresponding author. Tel.: +81-28-658-5151; fax: +81-28-658-5488
e-mail: hmatsugu{at}tcc.pref.tochigi.jp

Objective: The standard operation for patients with stage IA lung adenocarcinoma is considered to be a lobectomy. Recently, some researchers have reported that patients with tumors showing greater proportions of ground-glass opacity (GGO) at computed tomography (CT) could be candidates for limited resection, because of its less aggressive nature. However, the lack of a precise definition or standard measuring method of GGO prevents its general use as an index for planning limited resection. Therefore, we attempted to define GGO based on CT number and measured it more objectively. Methods: Between 1998 and 2001, 90 patients with clinical stage IA adenocarcinoma, who underwent standard or intentional limited resection and whose images of chest high-resolution CT were preserved in Digital Imaging and Communications in Medicine (DICOM) format, constituted the study population. The tumor shadow seen on the solid window (WL, –160 HU; WW, 2 HU) was regarded as the central solid area of the tumor seen on the lung window, and GGO was defined as the whole tumor area with the exception of the central solid area. Each area was measured using Scion Image (Scion Corp., Frederick, MD). We analyzed the relationship between the proportion of GGO and both of pathologic findings and recurrence. Results: Among the 90 tumors, 31 (34.4%) were calculated to have a GGO area greater than or equal to 50%. Of these, 27 (87%) tumors were bronchioloalveolar carcinoma. Lymphatic and vascular invasions, or nodal involvement were found only in patients with a smaller proportion of GGO (<50%) (P<0.05). During the follow-up period (median 36 months), recurrences occurred in eight patients who were diagnosed as having tumors showing smaller proportion of GGO (<50%). Conclusions: Tumors with a greater proportion of GGO measured by our method are thought to have a less invasive nature. Our objective measuring method of GGO could be useful for future multicenter trials to elucidate the value of limited resection for clinical stage IA adenocarcinoma based on the proportion of GGO.

Key Words: Lung neoplasms • High-resolution computed tomography • Lung neoplasms • Adenocarcinoma • Bronchioloalveolar carcinoma • Limited operation • Ground-glass opacity

This article has been cited by other articles:

				T. Hashizume, K. Yamada, N. Okamoto, H. Saito, F. Oshita, Y. Kato, H. Ito, H. Nakayama, Y. Kameda, and K. Noda Prognostic Significance of Thin-Section CT Scan Findings in Small-Sized Lung Adenocarcinoma Chest, February 1, 2008; 133(2): 441 - 447. [Abstract] [Full Text] [PDF]

				N. Yamada, M. Kusumoto, A. Maeshima, K. Suzuki, and Y. Matsuno Correlation of the Solid Part on High-resolution Computed Tomography with Pathological Scar in Small Lung Adenocarcinomas Jpn. J. Clin. Oncol., December 1, 2007; 37(12): 913 - 917. [Abstract] [Full Text] [PDF]

				Y. Ohta, Y. Shimizu, T. Kobayashi, O. Matsui, H. Minato, I. Matsumoto, and G. Watanabe Pathologic and Biological Assessment of Lung Tumors Showing Ground-Glass Opacity Ann. Thorac. Surg., April 1, 2006; 81(4): 1194 - 1197. [Abstract] [Full Text] [PDF]

				M. Nakata, S. Sawada, M. Yamashita, H. Saeki, A. Kurita, S. Takashima, and K. Tanemoto Objective radiologic analysis of ground-glass opacity aimed at curative limited resection for small peripheral non-small cell lung cancer J. Thorac. Cardiovasc. Surg., June 1, 2005; 129(6): 1226 - 1231. [Abstract] [Full Text] [PDF]