CT Findings of Persistent Pure Ground Glass Opacity: Can We Predict the Invasiveness?

Background: To investigate whether CT findings can predict the invasiveness of persistent cancerous pureground glass opacity (pGGO) by correlating the CT imaging features of persistent pGGO with pathologicalchanges. Materials and
Methods: Ninety five patients with persistent pGGOs were included. Three radiologistsevaluated the morphologic features of these pGGOs at high resolution CT (HRCT). Binary logistic regressionwas used to assess the association between CT findings and histopathological classification (pre-invasive andinvasive groups). Receiver operating characteristic (ROC) curve analysis was performed to evaluate thediagnostic performance of diameters.
Results: A total of 105 pGGOs were identified. Between pre-invasive(atypical adenomatous hyperplasia, AAH, and adenocarcinoma in situ, AIS) and invasive group (minimallyinvasive adenocarcinoma, MIA and invasive lung adenocarcinomas, ILA), there were significant differencesin diameter, spiculation and vessel dilatation (p<0.05). No difference was found in air-bronchogram, bubblelucency,lobulated-margin, pleural indentation or vascular convergence (p>0.05). The optimal threshold valueof the diameters to predict the invasiveness of pGGO was 12.50mm.
Conclusions: HRCT features can predictthe invasiveness of persistent pGGO. The pGGO with a diameter more than 12.50mm, presences of spiculationand vessel dilatation are important factors to differentiate invasive adenocarcinoma from pre-invasive cancerouslesions.