Emphysema influence size discrepancy between radiologic and pathologic size measurement in subsolid lung adenocarcinomas.

Congress:

ECR 2020

Poster Number:

C-07548

Type:

Scientific Exhibit

Keywords:

Performed at one institution, Not applicable, Retrospective, Cancer, Observer performance, CT, Lung, Chest

Authors:

J. Bae, H. Park, J.-K. Lim, H. J. Lee, S. Y. Lee, H. Lee, M. H. Hahm; Daegu/KR

DOI:

10.26044/ecr2020/C-07548

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-07548

Table 2: PSN, part-solid nodule; NSN, nonsolid nodule; WTsize, whole tumor size; Psize,...

Table 3: PSN, part-solid nodule; NSN, nonsolid nodule; STsize, solid tumor size; PIsize,...

Table 4

Table 1: PYRs, Pack-years; FEV1, forced expiratory volume in 1 second; FVC, forced vital...

Results

Patient demographics (Table. 1)

The proportion of men and smokers was significantly higher in the emphysema group than in the normal lung group
Age, smoking pack‐years (PYRs), and emphysema score were significantly higher in the emphysema group
PFT, forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) were significantly lower in the emphysema group than in the normal lung group
No significant differences in nodule morphology, WTsize, STsize, or clinical T‐stage between the emphysema and normal lung groups

Comparison of whole tumor size measurements determined by radiology and pathology (Table. 2)

The mean WTsize and Psize were 2.5 cm ± 1.1 (range, 0.7–6.9 cm) and 2.0 cm ± 0.9 (range, 0.5–5.0 cm), respectively
Interobserver agreement of the diameters measured by the two observers was excellent for WTsize (ICC = 0.968 [95% CI: 0.960–0.975])
WTSD was significantly higher in the normal lung group (P = 0.001) and in part-solid nodules (PSNs) (P < 0.001)
In patients with a higher clinical T stage, WTSD was significantly higher (P < 0.001)
SDratio was only significantly higher in patients with normal lungs (P = 0.015)

Comparison of solid tumor size measurements determined by radiology and pathology

Interobserver agreement of the diameters measured by the two observers was excellent in STsize (ICC = 0.966 [95% CI: 0.957–0.974])
STSD was significantly higher in the emphysema group (P = 0.003) and in nonsolid nodules(NSNs) (P = 0.001). In patients with a lower clinical T stage, WTSD was significantly lower (P = 0.029). SDratio only significantly lower in patients with an NSN (P = 0.001) and a lower clinical T stage (P = 0.002) (Table. 3)
A total of 44 of the 268 nodules were upstaged, as were 16 of 60 in the emphysema group and 28 of 208 in the normal lung group. Overall, 37 of 60 nodules in the emphysema group were concordant between clinical and pathologic T staging, compared to 159 of 208 nodules in the normal group (Table. 4)