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Predicting pleural invasion using HRCT and 18F-FDG PET/CT in lung adenocarcinoma with pleural contact

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Abstract

Objective

To evaluate the relevance of high-resolution computed tomography (HRCT) findings and fluorine-18-fluorodeoxyglucose (18F-FDG) uptake for risk stratification of visceral pleural invasion by lung adenocarcinoma.

Methods

The HRCT findings and 18F-FDG uptake for lung adenocarcinomas with pleural contact on CT were retrospectively analyzed in 208 consecutive patients (94 females and 114 males; median age, 69.0 years) between January 2009 and December 2013, with institutional review board approval. The HRCT findings and maximum standardized uptake value (SUVmax) were recorded for each patient. Multivariate logistic regression was used for statistical analysis, and subgroup analysis stratified for whole tumor size ≤3 cm was also performed.

Results

Multivariate analysis showed that SUVmax [odds ratio (OR) 1.09, 95 % confidence interval (CI) 1.02–1.16, P = 0.014] and obtuse angle (OR 4.14, 95 % CI 1.97–8.74, P < 0.001) were significant independent predictors for visceral pleural invasion. Receiver operating characteristic (ROC) analysis showed that, compared with the multivariate models [area under the curve (Az) 0.819–0.829], SUVmax alone (Az 0.815) was useful in predicting visceral pleural invasion. In the subgroup analysis, multivariate analysis showed that SUVmax (OR 1.29, 95 % CI 1.12–1.50, P = 0.001) and contact length with the pleura (OR 1.13, 95 % CI 1.05–1.22, P = 0.001) were significant independent predictors for visceral pleural invasion. ROC analysis showed that SUVmax alone (Az 0.844) showed similar diagnostic performance to the multivariate models (Az 0.845–0.857).

Conclusions

SUVmax alone and multivariate models including SUVmax are useful for the prediction of visceral pleural invasion by lung adenocarcinoma.

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Conflict of interest

No potential conflicts of interest were disclosed.

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Authors and Affiliations

  1. Department of Radiology, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan

    Takashi Tanaka, Takayoshi Shinya, Shuhei Sato & Susumu Kanazawa

  2. Center for Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan

    Toshiharu Mitsuhashi

  3. Department of Pathology, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan

    Koichi Ichimura

  4. Department of General Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan

    Junichi Soh, Shinichi Toyooka & Shinichiro Miyoshi

  5. Okayama Diagnostic Imaging Center, 2-3-25, Daikucho, Okayama, 700-0913, Japan

    Mitsumasa Kaji

Authors
  1. Takashi Tanaka
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  2. Takayoshi Shinya
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  3. Shuhei Sato
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  7. Shinichi Toyooka
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  9. Shinichiro Miyoshi
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  10. Susumu Kanazawa
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Correspondence to Takashi Tanaka.

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Tanaka, T., Shinya, T., Sato, S. et al. Predicting pleural invasion using HRCT and 18F-FDG PET/CT in lung adenocarcinoma with pleural contact. Ann Nucl Med 29, 757–765 (2015). https://doi.org/10.1007/s12149-015-0999-x

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  • DOI: https://doi.org/10.1007/s12149-015-0999-x

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