Multi-Slice Spiral CT Perfusion Imaging for Blood Supply of Pulmonary Mixed Ground-Glass Nodules_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

BaoJunhui ¹ , YanQiaohuan ² , LiuZhenxing ³ , WangJunying ¹ ^# ,  LvYinggang ¹

1. Image Second Division, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, 056002, China;
2. ;
3. ;

Corresponding?author：

LvYinggang, Email: lvying23gang@126.com

Keywords：

CT perfusion imaging; Pulmonary ground-glass nodules; Blood supply; Diagnosis

DOI：

10.7507/1671-6205.2016065

Video：

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Objective To investigate the clinical value of multi-slice spiral CT perfusion imaging for blood supply of pulmonary mixed ground-glass nodules (mGGN). Methods The mGGN patients were retrospectively analyzed from March 2011 to May 2015 in Affiliated Hospital of Hebei University of Engineering, Handan First Hospital and Xingtai People's Hospital. Multi-slice spiral CT perfusion imaging for blood supply was applied to evaluate the blood supply of solid lesions in mGGN, and the diagnostic values of CT perfusion parameters were compared for differentiating the benigh mGGN from the malignant mGGN. Results Totally 97 mGGN patients were enrolled in this study, in which 80 were malignant mGGN and 17 were benigh mGGN. Blood volume (BV), peak enhancement image (PEI) and permeability surface (PS) in malignant mGGN lesions were higher than those of benign lesions, while the time to peak was less than that of benign lesions, and the differences were all statistically significant (P < 0.05). BV, PEI and PS in minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC) patients were significantly higher than those in the patients with precancerous lesions (P < 0.05). BV and PS in IAC patients were significantly higher than those in MIA patients (P < 0.05). Logistic regression analysis showed that IAC, MIA and the precancerous lesions, BV, PEI and PS were positively correlated with mGGN. Receiver operating characteristic (ROC) curve showed that the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy rates with BV+PS+PEI combined, were 95.28%, 86.65%, 91.10%, 87.52% and 91.76%, respectively, while the area under ROC curve was significantly higher than those with single parameter (P < 0.05). Conclusion Multi-slice spiral CT perfusion imaging can evaluate the blood supply of mGGN, and BV+PS+PEI combined can be used in differentiation of the benigh and malignant mGGN.

Citation： Bao Junhui, Yan Qiaohuan, Liu Zhenxing, Wang Junying, Lv Yinggang. Multi-Slice Spiral CT Perfusion Imaging for Blood Supply of Pulmonary Mixed Ground-Glass Nodules. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(3): 279-283. doi: 10.7507/1671-6205.2016065 Copy

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3.	周安樂, 周康榮, 顏志平, 等.利用CT灌注成像研究轉移性肺癌的血供.中華放射學雜志, 2007, 41:366-371.
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5.	Poruk KE, Kim Y, Cameron JL, et al. What is the significance of indeterminate pulmonary nodules in patients undergoing resection for pancreatic adenocarcinoma. J Gastrointest Surg, 2015, 19:841-847.
6.	阮超美, 陳文靜, 鄭列, 等.CT灌注成像在肺部腫物診斷及鑒別診斷中的應用研究.癌癥, 2007, 26:78-83.
7.	楊淑琴, 侯鐵, 張千, 等.多層螺旋CT灌注成像技術在孤立性肺結節診斷及鑒別診斷中的應用.吉林大學學報(醫學版), 2008, 34:890-893.
8.	Valente G, Mamo C, Bena A, et al. Prognostic significance of microvessel density and vascular endothelial growth factor expression in sinonasal carcinomas. Hum Pathol, 2006, 37:391-400.
9.	Zhao YR, de Bock GH, Vliegenthart R, et al. Performance of computer-aided detection of pulmonary nodules in low-dose CT: comparison with double reading by nodule volume. Eur Radiol, 2012, 22:2076-2084.
10.	譚澤兵, 張子曙, 王云華, 等.多層螺旋CT灌注成像評價肺癌的血供特征.湖南師范大學學報(醫學版), 2009, 6:42-47.
11.	Xiang WJ, Xing YF, Jiang S, et al. Morphological factors differentiating between early lung adenocarcinomas appearing as pure ground-glass nodules measuring≤10 mm on thin-section computed tomography. Cancer Imaging, 2014, 14:33.
12.	Ma ZJ, Yang GZ, Wang J. Analysis of 96 cases of solitary pulmonary nodule diagnosed by MSCT. Chinese-German J Clin Oncol, 2014, 13:115-118.
13.	袁小東, 敖國昆, 全昌斌, 等.肺雙重血供的CT灌注技術及其應用于肺結核的初步研究.中華臨床醫師雜志(電子版), 2011, 5:5913-5919.

1. Barr MP, Gray SG, Gately K, et al. Vascular endothelial growth factor is an autocrine growth factor, signaling through neuropilin-1 in non-small cell lung cancer. Mol Cancer, 2015, 14:45.
2. Xie XQ, Zhao YR, Snijder RA, et al. Sensitivity and accuracy of volumetry of pulmonary nodules on low-dose 16-and 64-row multi-detector CT: an anthropomorphic phantom study. Eur Radiol, 2013, 23:139-147.
3. 周安樂, 周康榮, 顏志平, 等.利用CT灌注成像研究轉移性肺癌的血供.中華放射學雜志, 2007, 41:366-371.
4. Aoki T. Growth of pure ground-glass lung nodule detected at computed tomography. J Thorac Dis, 2015, 7:E326-E328.
5. Poruk KE, Kim Y, Cameron JL, et al. What is the significance of indeterminate pulmonary nodules in patients undergoing resection for pancreatic adenocarcinoma. J Gastrointest Surg, 2015, 19:841-847.
6. 阮超美, 陳文靜, 鄭列, 等.CT灌注成像在肺部腫物診斷及鑒別診斷中的應用研究.癌癥, 2007, 26:78-83.
7. 楊淑琴, 侯鐵, 張千, 等.多層螺旋CT灌注成像技術在孤立性肺結節診斷及鑒別診斷中的應用.吉林大學學報(醫學版), 2008, 34:890-893.
8. Valente G, Mamo C, Bena A, et al. Prognostic significance of microvessel density and vascular endothelial growth factor expression in sinonasal carcinomas. Hum Pathol, 2006, 37:391-400.
9. Zhao YR, de Bock GH, Vliegenthart R, et al. Performance of computer-aided detection of pulmonary nodules in low-dose CT: comparison with double reading by nodule volume. Eur Radiol, 2012, 22:2076-2084.
10. 譚澤兵, 張子曙, 王云華, 等.多層螺旋CT灌注成像評價肺癌的血供特征.湖南師范大學學報(醫學版), 2009, 6:42-47.
11. Xiang WJ, Xing YF, Jiang S, et al. Morphological factors differentiating between early lung adenocarcinomas appearing as pure ground-glass nodules measuring≤10 mm on thin-section computed tomography. Cancer Imaging, 2014, 14:33.
12. Ma ZJ, Yang GZ, Wang J. Analysis of 96 cases of solitary pulmonary nodule diagnosed by MSCT. Chinese-German J Clin Oncol, 2014, 13:115-118.
13. 袁小東, 敖國昆, 全昌斌, 等.肺雙重血供的CT灌注技術及其應用于肺結核的初步研究.中華臨床醫師雜志(電子版), 2011, 5:5913-5919.

Chinese Journal of Respiratory and Critical Care Medicine

Multi-Slice Spiral CT Perfusion Imaging for Blood Supply of Pulmonary Mixed Ground-Glass Nodules

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