Is a 5-mm diameter an appropriate cut-off value for the diagnosis of atypical adenomatous hyperplasia and adenocarcinoma in situ on chest computed tomography and pathological examination?

Journal of Thoracic Disease
Xiaohuan PanYubao Guan

Abstract

Preinvasive lesions, such as atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS), usually appear as pure ground-glass nodules (pGGNs) on thin-section computed tomography (TSCT). AAH is usually less than 5 mm wide on imaging and pathological examinations. We aimed to determine whether a 5-mm cut-off value was appropriate for the diagnosis of AAH and AIS. We retrospectively analyzed the performance of TSCT in evaluating 80 pathologically confirmed preinvasive lesions (33 AAH lesions in 31 patients and 47 AIS lesions in 45 patients). We compared the following characteristics between the AAH and AIS groups: lesion diameter, density, rim, lobulation, spiculation, vacuole sign, aerated bronchus sign, pleural indentation sign, and pathological findings. All 80 lesions appeared as pGGNs. On TSCT, the average diameter of AAH lesions (6.0±1.64 mm) was significantly smaller than that of AIS lesions (8.7±3.16 mm; P<0.001). The area under the curve (AUC) for diameter was 0.792, and the best diagnostic cut-off value was 6.99 mm. On gross pathological examination, the average diameter of AAH lesions (4.6±1.99 mm) was significantly smaller that of AIS lesions (6.8±2.06 mm; P<0.001). The AUC was 0.794, and the best diagnosti...Continue Reading

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