A Study On Thin-section CT And Radiomics Distinguish Lung Adenocarcinoma Of Pathological Subtype Which Performance Of Pure Ground-glass Nodule

Part I.Thin-section CT distinguish lung adenocarcinoma of pathological subtype which performance of pure ground-glass nodule Purpose:Analysis performance of pure ground-glass nodule(pGGN)atypical adenomatous hyperplasia(AAH),adenocarcinoma in situ(AIS),minimally invasive adenocarcinoma(MIA)and invasive adenocarcinoma(IAC)from thin-section CT(TSCT),explored four TSCT on diagnosis and differential diagnosis value..Materials and Methods:Retrospectively analyzed that confirmed by surgical pathology were performance of pGGN,including 85 patients with AAH(93 nodules),132 patients with AIS(134 nodules),226 patients with MIA(229 nodules)and 102 patients with IAC(103 nodules)TSCT performance,analysis and comparison maximum diameter,the average CT value,which lung,pleura position,edge,shape,lobulation sign,spicule sign,vocule sign,pleura traction sign,air bronchogram sign as well as differences in patient's age,gender of the four groups of nodules.Results:The maximum diameter mean of AAH is(6.31±1.69)mm,the maximum diameter of AIS is(8.84±2.83)mm,the maximum diameter of MIA is(10.29±4.10)mm,and the maximum diameter of IAC is(16.50±5.62)mm.The average CT value of AAH is(-658.3±75.3)HU,and the average CT value of AIS is(-629.9±85.5)HU,and the average CT value of MIA is(-575.1±110.5)HU,and the average CT value of IAC is(-517.1±128.7)HU.AAH compared with AIS,single factor analysis of the maximum diameter,average CT value,vacuolar sign,and pleural traction sign difference had statistical significance.The maximum diameter,average CT value and vacuolar sign difference were statistically significant.AAH with AIS optimum cutoff value of maximum diameter of 6.995 mm,AUC=0.804,the sensitivity of 82.8%,specificity of 63.4%,the average CT value optimum cutoff value is-647.7 HU,AUC=0.593,the sensitivity of 55.2%,specificity of 62.4%;The maximum diameter combined with the average CT value and vocule sign of Receiver operating characteristic,AUC=0.839,67.9% of sensitivity and 84.9% of specificity.The comparison of AIS and MIA,the single factor analysis of the maximum diameter,average CT value,and the Lobulation sign of the differentiation were statistically significant;The difference of the maximum diameter and average CT value of multi-factor analysis was statistically significant.AIS and MIA the optimum cutoff value maximum diameter of 9.82 mm,AUC=0.622,sensitivity of 49.3%,specificity of 73.9%,the average CT value optimum cutoff value is-630.3HU,AUC=0.646,the sensitivity of 67.2%,specificity of 56.0%,maximum diameter combined with the average CT value of the AIS and MIA of ROC curve,AUC=0.701,57.2% of sensitivity and 75.4% of specificity.Comparison between MIA and IAC,single factor analysis of the maximum diameter,average CT value,shape,lobulation sign,spicule sign,pleural traction and air bronchogram differences were statistically significant;The difference of the maximum diameter and average CT value of multi-factor analysis was statistically significant.MIA and IAC the optimum cutoff value maximum diameter of 11.75 mm,AUC=0.834,sensitivity of 80.6%,specificity of 73.8%,and the average CT value optimum cutoff value was-489.3HU,AUC=0.636,the sensitivity of 44.7%,specificity of 79.9%,maximum diameter combined with the average CT value of the MIA and IAC of ROC curve,AUC=0.863,85.4% of sensitivity and 76.9% of specificity.Conclusion:1.TSCT has a high value for the identification of AAH and AIS in pGGN,and the maximum diameter,CT value and vacuolar sign are the significant CT signs.The average maximum diameter and density of AIS were higher than AAH,and the occurrence rate of vacuolar sign in AIS is higher than AAH.2.TSCT has a certain value for the identification of AIS and MIA in pGGN,and the maximum diameter,CT value are the significant CT signs.The average maximum diameter and density of MIA were higher than AIS.3.TSCT has a high value for the identification of MIA and IAC in pGGN,and the maximum diameter,CT value and vacuolar sign are the significant CT signs.The average maximum diameter and density of IAC were higher than MIA.Part II.Radiomics distinguish lung adenocarcinoma of pathological subtype which performance of pure ground-glass nodule Purpose:The characteristics of AAH,AIS,MIA and IAC of pGGN were analyzed,and the identification value of the four subjects in the imaging group was discussed..Materials and Methods:Collected from January 2013 to October 2017 menstrual pathologically proven performance for pGGN 45 of AAH,81 of AIS,103 of MIA and 76 of IAC,according to the most and randomly divided into two independent data,the first part is the training group,the second part for the test group,use the L1 regularization Logistic regression model analysis and compare the different characteristics of the four groups of radiomics,using ROC curve and area under curve(AUC)in the evaluation of its differential efficiency.Results:AAH compared with AIS,the results of the training group AUC=0.864,sensitivity 74.07%,specificity 88.24%,total accuracy 79.55%;test results: AUC=0.697,sensitivity 51.85%,specificity 72.73%,total accuracy 57.89%.Comparison between AIS and MIA,the result of the training group is AUC=0.752,sensitivity 69.64%,specificity 75.00%,total accuracy 72.66%;Results: AUC=0.699,sensitivity 56.00%,specificity 77.42%,total accuracy 67.86%.Compared with IAC,the result of the training group is AUC=0.848,sensitivity 75.00%,specificity 81.13%,total accuracy 77.60%;The test group results showed that AUC=0.829,sensitivity 90.32%,specificity 65.22%,total accuracy 79.63%.Conclusion:1.Radiomics has high value in the identification of AAH and AIS in pGGN.2.Radiomics has a certain value in the identification of the AIS and MIA in pGGN.3.Radiomics has a high value in the identification of MIA and IAC in pGGN.