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Spectral Dual-Layer Computed Tomography Can Predict the Invasiveness of Ground-Glass Nodules: A Diagnostic Model Combined with Thymidine Kinase-1

Objectives: Few studies have explored the use of spectral dual-layer detector-based computed tomography (SDCT) parameters, thymidine kinase-1 (TK1), and tumor abnormal protein (TAP) for the detection of ground-glass nodules (GGNs). Therefore, we aimed to evaluate the quantitative and qualitative par...

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Autores principales: Wang, Tong, Yue, Yong, Fan, Zheng, Jia, Zheng, Yu, Xiuze, Liu, Chen, Hou, Yang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917490/
https://www.ncbi.nlm.nih.gov/pubmed/36769756
http://dx.doi.org/10.3390/jcm12031107
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author Wang, Tong
Yue, Yong
Fan, Zheng
Jia, Zheng
Yu, Xiuze
Liu, Chen
Hou, Yang
author_facet Wang, Tong
Yue, Yong
Fan, Zheng
Jia, Zheng
Yu, Xiuze
Liu, Chen
Hou, Yang
author_sort Wang, Tong
collection PubMed
description Objectives: Few studies have explored the use of spectral dual-layer detector-based computed tomography (SDCT) parameters, thymidine kinase-1 (TK1), and tumor abnormal protein (TAP) for the detection of ground-glass nodules (GGNs). Therefore, we aimed to evaluate the quantitative and qualitative parameters generated from SDCT for predicting the pathological subtypes of GGN-featured lung adenocarcinoma combined with TK1 and TAP. Material and Methods: Between July 2021 and September 2022, 238 patients with GGNs were retrospectively enrolled in this study. SDCT and tests for TK1 and TAP were performed preoperatively, and the lesions were divided into glandular precursor lesions (PGL), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma (IAC), according to the pathological results. A receiver operating characteristic (ROC) curve was used to compare the diagnostic performance of these parameters. Multivariate logistic regression analysis was performed to construct a joint diagnostic model and create a nomogram. Results: This study included 238 GGNs, including 41 atypical adenomatous hyperplasias (AAH), 62 adenocarcinomas in situ (AIS), 49 MIA, and 86 IAC, with a high proportion of women, non-smokers, and pure ground-glass nodule (pGGN). CT100 keV (a/v), electronic density (EDW) (a/v), Daverage, Dsolid, TK1, and TAP of MIA and IAC were higher than those of PGL. The effective atomic number (Zeff (a/v)) was lower in MIA and IAC than in PGL (all p < 0.05). Logistic regression analysis showed that Zeff (a), EDW (a), TK1, Daverage, and internal bronchial morphology were crucial factors in predicting the aggressiveness of GGN. Zeff (a) had the highest diagnostic performance with an area under the ROC curve (AUC) = 0.896, followed by EDW (a) (AUC = 0.838) and CT100 keVa (AUC = 0.819). The diagnostic model and nomogram constructed using these five parameters (Zeff (a) + EDW (a) + CT100 keVa + Daverage + TK1) had an AUC = 0.933, which was higher than the individual parameters (p < 0.05). Conclusions: Multiple quantitative and functional parameters can be selected based on SDCT, especially Zeff (a) and EDW (a), which have high sensitivity and specificity for predicting GGNs’ invasiveness. Additionally, the combination of TK1 can further improve diagnostic performance, and using a nomogram is helpful for individualized predictions.
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spelling pubmed-99174902023-02-11 Spectral Dual-Layer Computed Tomography Can Predict the Invasiveness of Ground-Glass Nodules: A Diagnostic Model Combined with Thymidine Kinase-1 Wang, Tong Yue, Yong Fan, Zheng Jia, Zheng Yu, Xiuze Liu, Chen Hou, Yang J Clin Med Article Objectives: Few studies have explored the use of spectral dual-layer detector-based computed tomography (SDCT) parameters, thymidine kinase-1 (TK1), and tumor abnormal protein (TAP) for the detection of ground-glass nodules (GGNs). Therefore, we aimed to evaluate the quantitative and qualitative parameters generated from SDCT for predicting the pathological subtypes of GGN-featured lung adenocarcinoma combined with TK1 and TAP. Material and Methods: Between July 2021 and September 2022, 238 patients with GGNs were retrospectively enrolled in this study. SDCT and tests for TK1 and TAP were performed preoperatively, and the lesions were divided into glandular precursor lesions (PGL), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma (IAC), according to the pathological results. A receiver operating characteristic (ROC) curve was used to compare the diagnostic performance of these parameters. Multivariate logistic regression analysis was performed to construct a joint diagnostic model and create a nomogram. Results: This study included 238 GGNs, including 41 atypical adenomatous hyperplasias (AAH), 62 adenocarcinomas in situ (AIS), 49 MIA, and 86 IAC, with a high proportion of women, non-smokers, and pure ground-glass nodule (pGGN). CT100 keV (a/v), electronic density (EDW) (a/v), Daverage, Dsolid, TK1, and TAP of MIA and IAC were higher than those of PGL. The effective atomic number (Zeff (a/v)) was lower in MIA and IAC than in PGL (all p < 0.05). Logistic regression analysis showed that Zeff (a), EDW (a), TK1, Daverage, and internal bronchial morphology were crucial factors in predicting the aggressiveness of GGN. Zeff (a) had the highest diagnostic performance with an area under the ROC curve (AUC) = 0.896, followed by EDW (a) (AUC = 0.838) and CT100 keVa (AUC = 0.819). The diagnostic model and nomogram constructed using these five parameters (Zeff (a) + EDW (a) + CT100 keVa + Daverage + TK1) had an AUC = 0.933, which was higher than the individual parameters (p < 0.05). Conclusions: Multiple quantitative and functional parameters can be selected based on SDCT, especially Zeff (a) and EDW (a), which have high sensitivity and specificity for predicting GGNs’ invasiveness. Additionally, the combination of TK1 can further improve diagnostic performance, and using a nomogram is helpful for individualized predictions. MDPI 2023-01-31 /pmc/articles/PMC9917490/ /pubmed/36769756 http://dx.doi.org/10.3390/jcm12031107 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wang, Tong
Yue, Yong
Fan, Zheng
Jia, Zheng
Yu, Xiuze
Liu, Chen
Hou, Yang
Spectral Dual-Layer Computed Tomography Can Predict the Invasiveness of Ground-Glass Nodules: A Diagnostic Model Combined with Thymidine Kinase-1
title Spectral Dual-Layer Computed Tomography Can Predict the Invasiveness of Ground-Glass Nodules: A Diagnostic Model Combined with Thymidine Kinase-1
title_full Spectral Dual-Layer Computed Tomography Can Predict the Invasiveness of Ground-Glass Nodules: A Diagnostic Model Combined with Thymidine Kinase-1
title_fullStr Spectral Dual-Layer Computed Tomography Can Predict the Invasiveness of Ground-Glass Nodules: A Diagnostic Model Combined with Thymidine Kinase-1
title_full_unstemmed Spectral Dual-Layer Computed Tomography Can Predict the Invasiveness of Ground-Glass Nodules: A Diagnostic Model Combined with Thymidine Kinase-1
title_short Spectral Dual-Layer Computed Tomography Can Predict the Invasiveness of Ground-Glass Nodules: A Diagnostic Model Combined with Thymidine Kinase-1
title_sort spectral dual-layer computed tomography can predict the invasiveness of ground-glass nodules: a diagnostic model combined with thymidine kinase-1
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917490/
https://www.ncbi.nlm.nih.gov/pubmed/36769756
http://dx.doi.org/10.3390/jcm12031107
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