Exploring the clinical value of multiplanar volume rendering technology in diagnosising the invasiveness of pulmonary ground glass nodules

doi:10.3877/cma.j.issn.1674-6902.2024.04.013

Abstract

Abstract:

Objective

Exploring the clinical significance of Multiplanar volume rendering (MPVR) technology in diagnosising the invasiveness of pulmonary ground glass nodules.

Methods

A retrospective analysis was conducted on 325 neoplastic GGNs, 114 adenocarcinoma in situ (AIS), 104 minimally invasive adenocarcinoma (MIA), and 107 invasive adenocarcinoma (IAC) in 303 patients between January 2020 and May 2023. The internal performance of GGN were divided into Ⅰ-Ⅴ types, and the external morphology were divided into Ⅰ-Ⅲ types according to the multiplanar volume rendering (MPVR) performance. Define MIA and IAC as invasive lesions(ILs), and based on the ratio of the maximum diameter of solitary nodules in GGN on MPVR to the 3D maximum diameter of GGN, and then the cutoff value for distinguishing invasive lesions and invasive adenocarcinoma were obtained via ROC analysis.

Results

The internal manifestation of AIS, MIA, IAC on MPVR were mainly type Ⅰ, type Ⅴ and type Ⅳ, and statistical significance (P<0.001) were found between the three groups. there also were statistically significant difference between AIS and IAC in type Ⅱ, and between AIS and MIA, IAC in type Ⅲ (each P<0.001 ). The external manifestation of AIS, MIA, IAC on MPVR were mainly type Ⅰ, type Ⅱ, and type Ⅲ, and statistical significance (P<0.001) were found between the three groups. For distinguishing invasive lesions and invasive adenocarcinoma, the cutoff value for the ratio of the maximum diameter of solitary nodules in GGN on MPVR to the 3D maximum diameter of GGN was 0.5 (AUC: 0.816, sensitivity: 71.93, specificity: 85.71, P<0.001), and 0.508 (AUC: 0.883, sensitivity: 87.5, specificity: 79.03, P<0.001).

Conclusion

MPVR technology has important role in evaluating the invasiveness of pulmonary ground glass nodules and has guiding significance for clinical practice.

Key words: Ground glass nodules, Multiplanar volume rendering, Computed tomography, Carcinoma in situ, microinvasive/invasive adenocarcinoma, lung

Tingwei Xiong, Yang Tao, Wangjia Li, Binjie Fu, Zhigang Chu, Fajin Lv. Exploring the clinical value of multiplanar volume rendering technology in diagnosising the invasiveness of pulmonary ground glass nodules[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2024, 17(04): 575-579.

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References 23

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GGN内部表现MPVR分型	AIS(n＝114)	MIA(n＝104)	IAC(n＝107)	P值
Ⅰ型	86(75.44)	18(17.31)	0(0)	0.000^a
Ⅱ型	23(20.18)	14(13.46)	5(4.67)	0.000^b
Ⅲ型	4(3.51)	13(12.50)	24(22.43)	0.000^bc
Ⅳ型	0(0)	7(6.73)	61(57.01)	0.000^a
Ⅴ型	1(0.88)	52(50.00)	17(15.89)	0.000^a

GGN内部表现MPVR分型	AIS(n＝114)	MIA(n＝104)	IAC(n＝107)	P值
Ⅰ型	86(75.44)	18(17.31)	0(0)	0.000^a
Ⅱ型	23(20.18)	14(13.46)	5(4.67)	0.000^b
Ⅲ型	4(3.51)	13(12.50)	24(22.43)	0.000^bc
Ⅳ型	0(0)	7(6.73)	61(57.01)	0.000^a
Ⅴ型	1(0.88)	52(50.00)	17(15.89)	0.000^a

GGN外部表现MPVR分型	AIS(n＝114)	MIA(n＝104)	IAC(n＝107)	P值
Ⅰ型	99(86.84)	24(23.08)	1(0.93)	0.000^a
Ⅱ型	12(10.53)	61(58.65)	33(30.84)	0.000^a
Ⅲ型	3(2.63)	19(18.27)	73(68.22)	0.000^a

GGN外部表现MPVR分型	AIS(n＝114)	MIA(n＝104)	IAC(n＝107)	P值
Ⅰ型	99(86.84)	24(23.08)	1(0.93)	0.000^a
Ⅱ型	12(10.53)	61(58.65)	33(30.84)	0.000^a
Ⅲ型	3(2.63)	19(18.27)	73(68.22)	0.000^a

GGN最大径与GGN3D长径比值截断值	0.5
AUC值	0.816
敏感性	71.93
特异性	85.71
Youden指数	0.5764
P值	0.000

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