CT-defined Visceral Pleural Invasion in T1 Lung Adenocarcinoma: Lack of Relationship to Disease-Free Survival

Radiology
Hyungjin KimChang Min Park

Abstract

BackgroundPathologic visceral pleural invasion (pVPI) leads to upstaging from T1 to T2. However, it is unclear whether the CT features for pVPI can be reliably used as a clinical T2 descriptor for preoperative staging.PurposeTo validate the diagnostic accuracy and analyze the prognostic value of CT findings for the prediction of pVPI in patients with resected node-negative lung adenocarcinoma.Materials and MethodsThis retrospective cohort study included clinical T1N0M0 adenocarcinomas resected between 2009 and 2015. The diagnostic CT findings suggestive of pVPI were evaluated by a thoracic radiologist. The accuracy of diagnostic CT findings in relation to pVPI and accuracy for disease-free survival (DFS) were evaluated by using test performance metrics and multivariable Cox regression analysis, respectively.ResultsThe authors analyzed 695 patients (median age, 63 years; 411 women). Data for pVPI were not available in six patients. The accuracy of CT features for pVPI ranged from 62.7% (432 of 689 patients) to 72.3% (498 of 689 patients). Positive predictive values ranged from 44.1% (173 of 392 patients) to 56.4% (88 of 156 patients), which indicated that about half of the CT-based predictions were false-positive. Multivariable ...Continue Reading

References

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