Ground glass

Abstract: Objective Our previous trial for small ground-glass opacity nodule on high-resolution computed tomography suggested all these cancers might have been radically managed with limited resection. Good correlation between radiologic and pathologic findings in early lung adenocarcinomas has been reported. We aimed to confirm limited resection efficacy as radical surgery in patients with high-resolution computed tomography-indicated minimally invasive lung cancer. The purpose of this interim analysis is to report the details of the patient and nodule characteristics, intraoperative cytology capability as a negative margin indicator, and patient outcome with the median follow-up period of 7 years and 4 months. Methods Enrollment required patients with a tumor ≤2 cm, diagnosed or suspected as a cT1N0M0 carcinoma in the lung periphery and depicted on high-resolution computed tomography as a sub-solid nodule with tumor disappearance ratio ≥0.5. We performed a wedge or segmental resection as appropriate. The primary endpoint is 10 year local recurrence-free survival rate. Results This study started in November 2003, and 101 patients were enrolled as of November 2009. Of them, 95 were eligible for analysis. There were 38 men and 57 women, aged 30-75, averaging 62 years. Tumor sizes ranged from 7 to 20 mm on computed tomography, averaging 15 mm. There were 11 Noguchi type A tumors, 54 type B tumors, 24 type C tumors, one malignant lymphoma and 5 non-cancerous lesions. All cancers showed no vessel invasion. With a median follow-up period of 88 months, there have been no recurrences. Conclusion So far, high-resolution computed tomography appears to predict non- or minimally invasive ground-glass opacity lung cancers with high reliability, warranting limited resection as curative surgery in this cohort.

Abstract: Objective Small pulmonary nodules are often followed up. This study aimed to establish radiographic criteria with which to accurately and reproducibly predict indolent cancers including adenocarcinoma in situ. Methods We examined correlations between pre-operative factors and surgical outcomes, including pathological findings and prognosis among 609 patients with clinical Stage IA lung adenocarcinoma that had been completely resected at multiple institutions. Indolent cancers were defined as tumors without lymphatic, blood vessel, pleural invasion or lymph node involvement (LY0V0PL0N0) regardless of stromal invasion. Results Pathological assessments of specimens of 35 of 85 (41%) pure ground glass opacity tumors including 3 (23%) of 13 pure ground glass opacity tumors ≤ 1 cm, revealed partially invasive components. Receiver operating characteristic curves for LY0V0PL0N0 revealed solid tumor size ≤ 6 mm on high-resolution computed tomography or maximum standardized uptake values ≤ 0.6 on 2-[18F]fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography as radiographic indolent tumor criteria for predicting indolent tumors. Among 216 (35.5%) of 609 patients who met these criteria, none developed recurrence over a median follow-up of 41.6 months. Conclusions Pure ground glass opacity lesions on high-resolution computed tomography could pathologically include invasive components and would not correspond to adenocarcinoma in situ. Solid tumor size on high-resolution computed tomography and maximum standardized uptake values on positron emission tomography/computed tomography can predict indolent LY0V0PL0N0 lung tumors that can be followed up.

Abstract: Coronavirus (COVID-19) pneumonia emerged in Wuhan, China, in December 2019. It was highly contagious spreading all over the world, with a rapid increase in the number of deaths. COVID-19 is characterized by fever, fatigue, dry cough, and dyspnea with variable chest imaging features which have been detected. In our study, we shared our experience of CT findings in proven cases of COVID-19 to recognize the different CT patterns to help in proper and accurate diagnosis. The most common CT features detected in COVID-19 cases were ground glass patches (93.3%) followed by subpleural linear abnormality (53.3%), air bronchogram (23.3%), and consolidation patches (23.3%), as well as bronchial wall thickening (16.7%), crazy paving pattern (13.3%), and discrete nodules surrounded by ground glass appearance (10%). Only one case had pleural effusion (3.3%). No cavitary lesions or specific lymph nodes were detected in any of the examined patients. The lung lesions showed typical diffuse, basal, and subpleural involvement with less affection of the upper lobes. CT imaging findings of COVID-19 can help in early and accurate diagnosis of COVID-19 and proper assessment of the severity of the disease.