A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical ia lung cancer (Japan Clinical Oncology Group 0201)

Kenji Suzuki, Teruaki Koike, Takashi Asakawa, Masahiko Kusumoto, Hisao Asamura, Kanji Nagai, Hirohito Tada, Tetsuya Mitsudomi, Masahiro Tsuboi, Taro Shibata, Haruhiko Fukuda, Harubumi Kato

Research output: Contribution to journalArticle

234 Citations (Scopus)

Abstract

Purpose: Pathological noninvasiveness needs to be precisely predicted in preoperative radiological examinations of patients with early lung cancer for the application of limited surgery. PATIENTS AND Methods: Patients with clinical T1N0M0 peripheral lung cancer were recruited. Radiological findings of the main tumor were evaluated as to ground-glass opacity with thin-section computed tomography. The primary end point was specificity, i.e., the proportion of patients with radiologically diagnosed invasive lung cancer to patients with pathologically diagnosed invasive lung cancer. The precision-based planned sample size was 450. We expected that the lower limit of the 95% confidence interval (CI) for specificity should be satisfied in ≥97% of patients. Results: We enrolled 811 patients from 31 institutions between December 2002 and May 2004. The primary end point was evaluated in 545 patients. The specificity and sensitivity for the diagnosis of pathologically diagnosed invasive cancer were 96.4% (161/167, 95% CI: 92.3-98.7%) and 30.4% (115/378, 95% CI: 25.8-35.3%), respectively, i.e., a negative result. Nevertheless, the specificity for lung adenocarcinoma ≤2.0 cm with ≤0.25 consolidation to the maximum tumor diameter was 98.7% (95% CI: 93.2-100.0%), and this criterion could be used to radiologically define early adenocarcinoma of the lung. Conclusions: Although our predetermined criterion for specificity was not statistically confirmed, radiological diagnosis of noninvasive lung cancer with a thin-section computed tomography scan corresponded well with pathological invasiveness. Radiological noninvasive peripheral lung adenocarcinoma could be defined as an adenocarcinoma ≤2.0 cm with ≤0.25 consolidation.

Original languageEnglish
Pages (from-to)751-756
Number of pages6
JournalJournal of Thoracic Oncology
Volume6
Issue number4
DOIs
Publication statusPublished - 2011 Apr
Externally publishedYes

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Medical Oncology
Lung Neoplasms
Japan
Tomography
Prospective Studies
Confidence Intervals
Neoplasms
Sample Size
Glass
Adenocarcinoma
Sensitivity and Specificity
Adenocarcinoma of lung

Keywords

  • Bronchioloalveolar carcinoma
  • Computed tomography
  • Ground-glass opacity
  • Limited resection
  • Thin-section

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical ia lung cancer (Japan Clinical Oncology Group 0201). / Suzuki, Kenji; Koike, Teruaki; Asakawa, Takashi; Kusumoto, Masahiko; Asamura, Hisao; Nagai, Kanji; Tada, Hirohito; Mitsudomi, Tetsuya; Tsuboi, Masahiro; Shibata, Taro; Fukuda, Haruhiko; Kato, Harubumi.

In: Journal of Thoracic Oncology, Vol. 6, No. 4, 04.2011, p. 751-756.

Research output: Contribution to journalArticle

Suzuki, Kenji ; Koike, Teruaki ; Asakawa, Takashi ; Kusumoto, Masahiko ; Asamura, Hisao ; Nagai, Kanji ; Tada, Hirohito ; Mitsudomi, Tetsuya ; Tsuboi, Masahiro ; Shibata, Taro ; Fukuda, Haruhiko ; Kato, Harubumi. / A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical ia lung cancer (Japan Clinical Oncology Group 0201). In: Journal of Thoracic Oncology. 2011 ; Vol. 6, No. 4. pp. 751-756.
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abstract = "Purpose: Pathological noninvasiveness needs to be precisely predicted in preoperative radiological examinations of patients with early lung cancer for the application of limited surgery. PATIENTS AND Methods: Patients with clinical T1N0M0 peripheral lung cancer were recruited. Radiological findings of the main tumor were evaluated as to ground-glass opacity with thin-section computed tomography. The primary end point was specificity, i.e., the proportion of patients with radiologically diagnosed invasive lung cancer to patients with pathologically diagnosed invasive lung cancer. The precision-based planned sample size was 450. We expected that the lower limit of the 95{\%} confidence interval (CI) for specificity should be satisfied in ≥97{\%} of patients. Results: We enrolled 811 patients from 31 institutions between December 2002 and May 2004. The primary end point was evaluated in 545 patients. The specificity and sensitivity for the diagnosis of pathologically diagnosed invasive cancer were 96.4{\%} (161/167, 95{\%} CI: 92.3-98.7{\%}) and 30.4{\%} (115/378, 95{\%} CI: 25.8-35.3{\%}), respectively, i.e., a negative result. Nevertheless, the specificity for lung adenocarcinoma ≤2.0 cm with ≤0.25 consolidation to the maximum tumor diameter was 98.7{\%} (95{\%} CI: 93.2-100.0{\%}), and this criterion could be used to radiologically define early adenocarcinoma of the lung. Conclusions: Although our predetermined criterion for specificity was not statistically confirmed, radiological diagnosis of noninvasive lung cancer with a thin-section computed tomography scan corresponded well with pathological invasiveness. Radiological noninvasive peripheral lung adenocarcinoma could be defined as an adenocarcinoma ≤2.0 cm with ≤0.25 consolidation.",
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author = "Kenji Suzuki and Teruaki Koike and Takashi Asakawa and Masahiko Kusumoto and Hisao Asamura and Kanji Nagai and Hirohito Tada and Tetsuya Mitsudomi and Masahiro Tsuboi and Taro Shibata and Haruhiko Fukuda and Harubumi Kato",
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T1 - A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical ia lung cancer (Japan Clinical Oncology Group 0201)

AU - Suzuki, Kenji

AU - Koike, Teruaki

AU - Asakawa, Takashi

AU - Kusumoto, Masahiko

AU - Asamura, Hisao

AU - Nagai, Kanji

AU - Tada, Hirohito

AU - Mitsudomi, Tetsuya

AU - Tsuboi, Masahiro

AU - Shibata, Taro

AU - Fukuda, Haruhiko

AU - Kato, Harubumi

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N2 - Purpose: Pathological noninvasiveness needs to be precisely predicted in preoperative radiological examinations of patients with early lung cancer for the application of limited surgery. PATIENTS AND Methods: Patients with clinical T1N0M0 peripheral lung cancer were recruited. Radiological findings of the main tumor were evaluated as to ground-glass opacity with thin-section computed tomography. The primary end point was specificity, i.e., the proportion of patients with radiologically diagnosed invasive lung cancer to patients with pathologically diagnosed invasive lung cancer. The precision-based planned sample size was 450. We expected that the lower limit of the 95% confidence interval (CI) for specificity should be satisfied in ≥97% of patients. Results: We enrolled 811 patients from 31 institutions between December 2002 and May 2004. The primary end point was evaluated in 545 patients. The specificity and sensitivity for the diagnosis of pathologically diagnosed invasive cancer were 96.4% (161/167, 95% CI: 92.3-98.7%) and 30.4% (115/378, 95% CI: 25.8-35.3%), respectively, i.e., a negative result. Nevertheless, the specificity for lung adenocarcinoma ≤2.0 cm with ≤0.25 consolidation to the maximum tumor diameter was 98.7% (95% CI: 93.2-100.0%), and this criterion could be used to radiologically define early adenocarcinoma of the lung. Conclusions: Although our predetermined criterion for specificity was not statistically confirmed, radiological diagnosis of noninvasive lung cancer with a thin-section computed tomography scan corresponded well with pathological invasiveness. Radiological noninvasive peripheral lung adenocarcinoma could be defined as an adenocarcinoma ≤2.0 cm with ≤0.25 consolidation.

AB - Purpose: Pathological noninvasiveness needs to be precisely predicted in preoperative radiological examinations of patients with early lung cancer for the application of limited surgery. PATIENTS AND Methods: Patients with clinical T1N0M0 peripheral lung cancer were recruited. Radiological findings of the main tumor were evaluated as to ground-glass opacity with thin-section computed tomography. The primary end point was specificity, i.e., the proportion of patients with radiologically diagnosed invasive lung cancer to patients with pathologically diagnosed invasive lung cancer. The precision-based planned sample size was 450. We expected that the lower limit of the 95% confidence interval (CI) for specificity should be satisfied in ≥97% of patients. Results: We enrolled 811 patients from 31 institutions between December 2002 and May 2004. The primary end point was evaluated in 545 patients. The specificity and sensitivity for the diagnosis of pathologically diagnosed invasive cancer were 96.4% (161/167, 95% CI: 92.3-98.7%) and 30.4% (115/378, 95% CI: 25.8-35.3%), respectively, i.e., a negative result. Nevertheless, the specificity for lung adenocarcinoma ≤2.0 cm with ≤0.25 consolidation to the maximum tumor diameter was 98.7% (95% CI: 93.2-100.0%), and this criterion could be used to radiologically define early adenocarcinoma of the lung. Conclusions: Although our predetermined criterion for specificity was not statistically confirmed, radiological diagnosis of noninvasive lung cancer with a thin-section computed tomography scan corresponded well with pathological invasiveness. Radiological noninvasive peripheral lung adenocarcinoma could be defined as an adenocarcinoma ≤2.0 cm with ≤0.25 consolidation.

KW - Bronchioloalveolar carcinoma

KW - Computed tomography

KW - Ground-glass opacity

KW - Limited resection

KW - Thin-section

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