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First published online January 5, 2009
British Journal of Radiology (2009) 82, 532-540
© 2009 British Institute of Radiology
doi: 10.1259/bjr/70480730
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British Journal of Radiology 82 (2009),532-540 ©2009 The British Institute of Radiology

One-dimensional quantitative evaluation of peripheral lung adenocarcinoma with or without ground-glass opacity on thin-section CT images using profile curves

M YANAGAWA, MD 1 K KURIYAMA, MD, PhD 2 Y KUNITOMI, MD 2 N TOMIYAMA, MD, PhD 1 O HONDA, MD, PhD 1 H SUMIKAWA, MD, PhD 1 A INOUE, MD, PhD 1 N MIHARA, MD, PhD 1 S YOSHIDA, MD 1 T JOHKOH, MD, PhD 3 and H NAKAMURA, MD, PhD 1

1 Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan, 2 Department of Radiology, National Hospital Organization Osaka National Hospital, Osaka, Japan, and 3 Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Hyogo, Japan

Correspondence: Masahiro Yanagawa, Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-city, Osaka, 565-0871, Japan. E-mail: m-yanagawa{at}radiol.med.osaka-u.ac.jp

The purpose of our investigation was to compare the usefulness of the subjective visual assessment of ground-glass opacity (GGO) with a quantitative method that used a profile curve to determine prognosis. 96 adenocarcinomas were studied. Three diameters ([D1]–[D3]) were defined for estimating the diameter of tumours on the monitor: the distance between two points was measured using software that displays a CT density profile across the tumour. One experienced and one less experienced radiologist independently evaluated the following six parameters: the three diameters [D1]–[D3]; the solid portion of total tumour in the two different ratios ([D2]/[D1], [D3]/[D1]); and the area ratio of GGO for total opacity to subjective visual evaluation. Interobserver agreement between the two radiologists of the diameters (mean bias± 1.96 standard deviations) was as follows: [D1], –0.7 ± 6 mm; [D2], 0.4 ± 4.4 mm; and [D3], –0.1 ± 4.2 mm (Bland and Altman's method). Interobserver agreement was fair in evaluating the area ratio of GGO (kappa test, {kappa}  =  0.309). Univariate logistic regression analysis revealed that two ratios ([D2]/[D1], [D3]/[D1]) might be significantly useful in estimating lymph node metastasis (p < 0.026), lymph duct invasion (p < 0.001) and recurrence (p < 0.015). Observation of the area ratio of GGO by an experienced radiologist would be necessary for estimating lymph node metastasis (p  =  0.04) and lymph duct invasion (p < 0.001). We concluded that the ratio of solid component to total tumour, which is obtainable in a more objective and simple way using profile curves obtained by software, is a more useful method of estimating prognosis than is visual assessment.






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