Visceral Pleural Invasion in Pulmonary Adenocarcinoma: Differences in CT Patterns between Solid and Subsolid Cancers.

Autor:	Heidinger BH; Departments of Radiology (B.H.H., U.S.N., C.d.M.M., A.C.M.F., A.A.B.) and Pathology (K.R.A., Y.C., P.A.V.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215; Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital, Medical University of Vienna, Austria (B.H.H., U.S.N., M.E.M.); and Seacoast Pathology/Aurora Diagnostics, Exeter, NH (K.R.A.)., Schwarz-Nemec U; Departments of Radiology (B.H.H., U.S.N., C.d.M.M., A.C.M.F., A.A.B.) and Pathology (K.R.A., Y.C., P.A.V.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215; Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital, Medical University of Vienna, Austria (B.H.H., U.S.N., M.E.M.); and Seacoast Pathology/Aurora Diagnostics, Exeter, NH (K.R.A.)., Anderson KR; Departments of Radiology (B.H.H., U.S.N., C.d.M.M., A.C.M.F., A.A.B.) and Pathology (K.R.A., Y.C., P.A.V.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215; Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital, Medical University of Vienna, Austria (B.H.H., U.S.N., M.E.M.); and Seacoast Pathology/Aurora Diagnostics, Exeter, NH (K.R.A.)., de Margerie-Mellon C; Departments of Radiology (B.H.H., U.S.N., C.d.M.M., A.C.M.F., A.A.B.) and Pathology (K.R.A., Y.C., P.A.V.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215; Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital, Medical University of Vienna, Austria (B.H.H., U.S.N., M.E.M.); and Seacoast Pathology/Aurora Diagnostics, Exeter, NH (K.R.A.)., Monteiro Filho AC; Departments of Radiology (B.H.H., U.S.N., C.d.M.M., A.C.M.F., A.A.B.) and Pathology (K.R.A., Y.C., P.A.V.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215; Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital, Medical University of Vienna, Austria (B.H.H., U.S.N., M.E.M.); and Seacoast Pathology/Aurora Diagnostics, Exeter, NH (K.R.A.)., Chen Y; Departments of Radiology (B.H.H., U.S.N., C.d.M.M., A.C.M.F., A.A.B.) and Pathology (K.R.A., Y.C., P.A.V.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215; Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital, Medical University of Vienna, Austria (B.H.H., U.S.N., M.E.M.); and Seacoast Pathology/Aurora Diagnostics, Exeter, NH (K.R.A.)., Mayerhoefer ME; Departments of Radiology (B.H.H., U.S.N., C.d.M.M., A.C.M.F., A.A.B.) and Pathology (K.R.A., Y.C., P.A.V.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215; Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital, Medical University of Vienna, Austria (B.H.H., U.S.N., M.E.M.); and Seacoast Pathology/Aurora Diagnostics, Exeter, NH (K.R.A.)., VanderLaan PA; Departments of Radiology (B.H.H., U.S.N., C.d.M.M., A.C.M.F., A.A.B.) and Pathology (K.R.A., Y.C., P.A.V.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215; Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital, Medical University of Vienna, Austria (B.H.H., U.S.N., M.E.M.); and Seacoast Pathology/Aurora Diagnostics, Exeter, NH (K.R.A.)., Bankier AA; Departments of Radiology (B.H.H., U.S.N., C.d.M.M., A.C.M.F., A.A.B.) and Pathology (K.R.A., Y.C., P.A.V.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215; Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital, Medical University of Vienna, Austria (B.H.H., U.S.N., M.E.M.); and Seacoast Pathology/Aurora Diagnostics, Exeter, NH (K.R.A.).
Jazyk:	angličtina
Zdroj:	Radiology. Cardiothoracic imaging [Radiol Cardiothorac Imaging] 2019 Aug 29; Vol. 1 (3), pp. e190071. Date of Electronic Publication: 2019 Aug 29 (Print Publication: 2019).
DOI:	10.1148/ryct.2019190071
Abstrakt:	Purpose: To analyze the incidence and CT patterns of visceral pleural invasion (VPI) in adenocarcinomas on the basis of their CT presentation as solid or subsolid nodules. Materials and Methods: A total of 286 adenocarcinomas in direct contact with a pleural surface, resected at an institution between 2005 and 2016, were included in this retrospective, institutional review board-approved study. CT size and longest contact length with a pleural surface were measured and their ratios computed. Pleural deviation, pleural thickening, spiculations, different pleural tag types, pleural effusion, and the CT appearance of transgression into an adjacent lobe or infiltration of surrounding tissue were evaluated. Fisher exact tests and simple and multiple logistic regression models were used. Results: Of the 286 nodules, 179 of 286 (62.6%) were solid and 107 of 286 (37.4%) were subsolid. VPI was present in 49 of 286 (17.1%) nodules and was significantly more frequent in solid (44 of 179; 24.6%) than in subsolid nodules (five of 107; 4.7%; P < .001). In solid nodules, multiple regression analysis showed an association of higher contact length-to-size ratio (adjusted odds ratio [OR], 1.02; P = .007) and the presence of multiple pleural tag types (adjusted OR, 5.88; P = .002) with VPI. In subsolid nodules, longer pleural contact length of the solid nodular component (adjusted OR, 1.27; P = .017) and the CT appearance of transgression or infiltration (adjusted OR, 10.75; P = .037) were associated with VPI. Conclusion: During preoperative evaluation of adenocarcinomas for the likelihood of VPI, whether a tumor manifests as a solid or a subsolid nodule is important to consider because the incidence of VPI is significantly higher in solid than in subsolid nodules. In addition, this study showed that the CT patterns associated with VPI differ between solid and subsolid nodules.© RSNA, 2019 Supplemental material is available for this article. See also the commentary by Elicker in this issue. Competing Interests: Disclosures of Conflicts of Interest: B.H.H. disclosed no relevant relationships. U.S.N. disclosed no relevant relationships. K.R.A. disclosed no relevant relationships. C.d.M.M. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: received money for expert testimony (Institut Servier, Olea Medical). Other relationships: disclosed no relevant relationships A.C.M.F. disclosed no relevant relationships. Y.C. disclosed no relevant relationships M.E.M. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: institution receives funding from Siemens Healthineers; receives payment for lectures from Siemens Healthineers; employed at Medical University of Vienna. Other relationships: disclosed no relevant relationships. P.A.V. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: consultant from Foundation Medicine, Gala Therapeutics. Other relationships: disclosed no relevant relationships A.A.B. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: consultant for Daiichi Paramaceutics, Spiration (Olympus Medical), and Hummingbird Diagnostics; provides expert testimony for CRICO Risk Management Foundation; receives royalties from Elsevier. Other relationships: disclosed no relevant relationships. (2019 by the Radiological Society of North America, Inc.)
Databáze:	MEDLINE
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