How should we manage small focal pure ground-glass opacity nodules on high-resolution computed tomography? A single institute experience

Masafumi Yamaguchi, Akio Furuya, Makoto Edagawa, Kenichi Taguchi, Shinichiro Shimamatsu, Gouji Toyokawa, Ryo Toyozawa, Kaname Nosaki, Fumihiko Hirai, Takashi Seto, Mitsuhiro Takenoyama, Yukito Ichinose

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Abstract

Background Although the detection of pure ground-glass opacity (p-GGO) nodules on high-resolution chest computed tomography (HRCT) often implies a diagnosis of lung adenocarcinoma, the management of p-GGO nodules remains under discussion. Objective To assess the correlation between the radiological and pathological diagnoses of small p-GGO on HRCT. Patients and methods This is a single-institution retrospective study. We analyzed 89 consecutive patients, including 33 patients with resected p-GGO nodule(s) equal or less than 20 mm in maximal diameter on axial images of HRCT. Results Thirty-nine patients underwent locoregional treatment (Treatment group), including surgical resection in 33 and stereotactic body radiation therapy in six. The remaining 50 patients were observed (Observation group) using periodic chest HRCT. The median follow-up time was 30.4 (4.9-102.5) months in the Treatment group and 44.8 (0.4-1125.8) months in the Observation group. During the follow-up period, the p-GGO nodules increased in size in eight patients over a median of 20.6 (12.1-50.6) months, with increased attenuation in three patients over a median of 20.6 (12.1-50.6) months, and either decreased in size or disappeared in four patients over a median of 6.9 (2.0-11.2) months. Thirty-three patients with 47 nodules underwent surgical resection, including 41 adenocarcinomas, one neuroendocrine tumor, three cases of atypical adenomatous hyperplasia and two benign lesions. The frequency of invasive adenocarcinoma was higher among the larger p-GGO nodules. Conclusions Careful observation and decision making with respect to the timing of intervention in cases of p-GGO nodules are warranted.

Original languageEnglish
Pages (from-to)258-263
Number of pages6
JournalSurgical Oncology
Volume24
Issue number3
DOIs
Publication statusPublished - Sep 1 2015

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Glass
Tomography
Thorax
Observation
Adenocarcinoma
Neuroendocrine Tumors
Hyperplasia
Decision Making
Radiotherapy
Therapeutics
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

How should we manage small focal pure ground-glass opacity nodules on high-resolution computed tomography? A single institute experience. / Yamaguchi, Masafumi; Furuya, Akio; Edagawa, Makoto; Taguchi, Kenichi; Shimamatsu, Shinichiro; Toyokawa, Gouji; Toyozawa, Ryo; Nosaki, Kaname; Hirai, Fumihiko; Seto, Takashi; Takenoyama, Mitsuhiro; Ichinose, Yukito.

In: Surgical Oncology, Vol. 24, No. 3, 01.09.2015, p. 258-263.

Research output: Contribution to journalArticle

Yamaguchi, M, Furuya, A, Edagawa, M, Taguchi, K, Shimamatsu, S, Toyokawa, G, Toyozawa, R, Nosaki, K, Hirai, F, Seto, T, Takenoyama, M & Ichinose, Y 2015, 'How should we manage small focal pure ground-glass opacity nodules on high-resolution computed tomography? A single institute experience', Surgical Oncology, vol. 24, no. 3, pp. 258-263. https://doi.org/10.1016/j.suronc.2015.08.004
Yamaguchi, Masafumi ; Furuya, Akio ; Edagawa, Makoto ; Taguchi, Kenichi ; Shimamatsu, Shinichiro ; Toyokawa, Gouji ; Toyozawa, Ryo ; Nosaki, Kaname ; Hirai, Fumihiko ; Seto, Takashi ; Takenoyama, Mitsuhiro ; Ichinose, Yukito. / How should we manage small focal pure ground-glass opacity nodules on high-resolution computed tomography? A single institute experience. In: Surgical Oncology. 2015 ; Vol. 24, No. 3. pp. 258-263.
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AU - Yamaguchi, Masafumi

AU - Furuya, Akio

AU - Edagawa, Makoto

AU - Taguchi, Kenichi

AU - Shimamatsu, Shinichiro

AU - Toyokawa, Gouji

AU - Toyozawa, Ryo

AU - Nosaki, Kaname

AU - Hirai, Fumihiko

AU - Seto, Takashi

AU - Takenoyama, Mitsuhiro

AU - Ichinose, Yukito

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N2 - Background Although the detection of pure ground-glass opacity (p-GGO) nodules on high-resolution chest computed tomography (HRCT) often implies a diagnosis of lung adenocarcinoma, the management of p-GGO nodules remains under discussion. Objective To assess the correlation between the radiological and pathological diagnoses of small p-GGO on HRCT. Patients and methods This is a single-institution retrospective study. We analyzed 89 consecutive patients, including 33 patients with resected p-GGO nodule(s) equal or less than 20 mm in maximal diameter on axial images of HRCT. Results Thirty-nine patients underwent locoregional treatment (Treatment group), including surgical resection in 33 and stereotactic body radiation therapy in six. The remaining 50 patients were observed (Observation group) using periodic chest HRCT. The median follow-up time was 30.4 (4.9-102.5) months in the Treatment group and 44.8 (0.4-1125.8) months in the Observation group. During the follow-up period, the p-GGO nodules increased in size in eight patients over a median of 20.6 (12.1-50.6) months, with increased attenuation in three patients over a median of 20.6 (12.1-50.6) months, and either decreased in size or disappeared in four patients over a median of 6.9 (2.0-11.2) months. Thirty-three patients with 47 nodules underwent surgical resection, including 41 adenocarcinomas, one neuroendocrine tumor, three cases of atypical adenomatous hyperplasia and two benign lesions. The frequency of invasive adenocarcinoma was higher among the larger p-GGO nodules. Conclusions Careful observation and decision making with respect to the timing of intervention in cases of p-GGO nodules are warranted.

AB - Background Although the detection of pure ground-glass opacity (p-GGO) nodules on high-resolution chest computed tomography (HRCT) often implies a diagnosis of lung adenocarcinoma, the management of p-GGO nodules remains under discussion. Objective To assess the correlation between the radiological and pathological diagnoses of small p-GGO on HRCT. Patients and methods This is a single-institution retrospective study. We analyzed 89 consecutive patients, including 33 patients with resected p-GGO nodule(s) equal or less than 20 mm in maximal diameter on axial images of HRCT. Results Thirty-nine patients underwent locoregional treatment (Treatment group), including surgical resection in 33 and stereotactic body radiation therapy in six. The remaining 50 patients were observed (Observation group) using periodic chest HRCT. The median follow-up time was 30.4 (4.9-102.5) months in the Treatment group and 44.8 (0.4-1125.8) months in the Observation group. During the follow-up period, the p-GGO nodules increased in size in eight patients over a median of 20.6 (12.1-50.6) months, with increased attenuation in three patients over a median of 20.6 (12.1-50.6) months, and either decreased in size or disappeared in four patients over a median of 6.9 (2.0-11.2) months. Thirty-three patients with 47 nodules underwent surgical resection, including 41 adenocarcinomas, one neuroendocrine tumor, three cases of atypical adenomatous hyperplasia and two benign lesions. The frequency of invasive adenocarcinoma was higher among the larger p-GGO nodules. Conclusions Careful observation and decision making with respect to the timing of intervention in cases of p-GGO nodules are warranted.

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