Research progress on the correlation between imaging characteristics and pathological invasion degree of early lung adenocarcinoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YANG Yantao , HUANG Yunchao , ZHAO Guangqiang ,  YE Lianhua

Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Kunming, 650000, P. R. China;

Corresponding author：

YE Lianhua, Email: Lhye1204@aliyun.com

Keywords：

Ground-glass nodule; lung adenocarcinoma; invasion; imaging characteristics; review

DOI：

10.7507/1007-4848.202203051

Video：

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Abstract Full text Figures/Tables Video References Cited by

With the development of multi-slice spiral computed tomography (CT) technology and the popularization of low-dose spiral CT screening, more and more adenocarcinomas presenting ground-glass nodule (GGN) are found. Pathological invasiveness is one of the important factors affecting the choice of treatment strategy and prognosis of patients with early lung adenocarcinoma. Imaging features have attracted wide attention due to their unique advantages in predicting the pathologic invasiveness of early lung adenocarcinoma. The imaging characteristics of GGN can be used to predict the pathologic invasiveness of lung adenocarcinoma and provide evidence for clinical decisions. However, the imaging parameters and numerical values for predicting pathologic invasiveness are still controversial, which will be reviewed in this paper.

Citation： YANG Yantao, HUANG Yunchao, ZHAO Guangqiang, YE Lianhua. Research progress on the correlation between imaging characteristics and pathological invasion degree of early lung adenocarcinoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(9): 1337-1343. doi: 10.7507/1007-4848.202203051 Copy

1.	The International Agency for Research on Cancer. World cancer report: Cancer research for cancer prevention. URL: https://www.iarc.who.int/featured-news/new-world-cancer-report/. (2020-02-04) [2022-03-10].
2.	李媛, 谢惠康, 武春燕. WHO胸部肿瘤分类(第5版)中肺肿瘤部分解读. 中国癌症杂志, 2021, 31(7): 574-580.
3.	Xinli W, Xiaoshuang S, Chengxin Y, et al. CT-assisted improvements in the accuracy of the intraoperative frozen section examination of ground-glass density nodules. Comput Math Methods Med, 2022, 2022: 8967643.
4.	Yotsukura M, Asamura H, Motoi N, et al. Long-term prognosis of patients with resected adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung. J Thorac Oncol, 2021, 16(8): 1312-1320.
5.	Watanabe Y, Hattori A, Nojiri S, et al. Clinical impact of a small component of ground-glass opacity in solid-dominant clinical stage ⅠA non-small cell lung cancer. J Thorac Cardiovasc Surg, 2022, 163(3): 791-801.
6.	Suzuki K, Watanabe SI, Wakabayashi M, et al. A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer. J Thorac Cardiovasc Surg, 2022, 163(1): 289-301.
7.	Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
8.	Zhang Y, Shen Y, Qiang JW, et al. HRCT features distinguishing pre-invasive from invasive pulmonary adenocarcinomas appearing as ground-glass nodules. Eur Radiol, 2016, 26(9): 2921-2928.
9.	Han L, Zhang P, Wang Y, et al. CT quantitative parameters to predict the invasiveness of lung pure ground-glass nodules (pGGNs). Clin Radiol, 2018, 73(5): 504.e1-504.e7.
10.	Chu ZG, Li WJ, Fu BJ, et al. CT characteristics for predicting invasiveness in pulmonary pure ground-glass nodules. AJR Am J Roentgenol, 2020, 215(2): 351-358.
11.	Fu F, Zhang Y, Wang S, et al. Computed tomography density is not associated with pathological tumor invasion for pure ground-glass nodules. J Thorac Cardiovasc Surg, 2021, 162(2): 451-459.
12.	Liu LH, Liu M, Wei R, et al. CT findings of persistent pure ground glass opacity: Can we predict the invasiveness? Asian Pac J Cancer Prev, 2015, 16(5): 1925-1928.
13.	Lee SM, Park CM, Goo JM, et al. Invasive pulmonary adenocarcinomas versus preinvasive lesions appearing as ground-glass nodules: Differentiation by using CT features. Radiology, 2013, 268(1): 265-273.
14.	Lim HJ, Ahn S, Lee KS, et al. Persistent pure ground-glass opacity lung nodules≥10 mm in diameter at CT scan: Histopathologic comparisons and prognostic implications. Chest, 2013, 144(4): 1291-1299.
15.	Li Q, Gu YF, Fan L, et al. Effect of CT window settings on size measurements of the solid component in subsolid nodules: Evaluation of prediction efficacy of the degree of pathological malignancy in lung adenocarcinoma. Br J Radiol, 2018, 91(1088): 20180251.
16.	Yoo RE, Goo JM, Hwang EJ, et al. Retrospective assessment of interobserver agreement and accuracy in classifications and measurements in subsolid nodules with solid components less than 8 mm: Which window setting is better? Eur Radiol, 2017, 27(4): 1369-1376.
17.	Lee KH, Goo JM, Park SJ, et al. Correlation between the size of the solid component on thin-section CT and the invasive component on pathology in small lung adenocarcinomas manifesting as ground-glass nodules. J Thorac Oncol, 2014, 9(1): 74-82.
18.	Cohen JG, Reymond E, Lederlin M, et al. Differentiating pre- and minimally invasive from invasive adenocarcinoma using CT-features in persistent pulmonary part-solid nodules in Caucasian patients. Eur J Radiol, 2015, 84(4): 738-744.
19.	Vansteenkiste JF, Cho BC, Vanakesa T, et al. Efficacy of the MAGE-A3 cancer immunotherapeutic as adjuvant therapy in patients with resected MAGE-A3-positive non-small-cell lung cancer (MAGRIT): A randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol, 2016, 17(6): 822-835.
20.	Liang J, Xu XQ, Xu H, et al. Using the CT features to differentiate invasive pulmonary adenocarcinoma from pre-invasive lesion appearing as pure or mixed ground-glass nodules. Br J Radiol, 2015, 88(1053): 20140811.
21.	Suzuki K, Koike T, Asakawa T, et al. A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical ⅠA lung cancer (Japan Clinical Oncology Group 0201). J Thorac Oncol, 2011, 6(4): 751-756.
22.	Asamura H, Hishida T, Suzuki K, et al. Radiographically determined noninvasive adenocarcinoma of the lung: Survival outcomes of Japan Clinical Oncology Group 0201. J Thorac Cardiovasc Surg, 2013, 146(1): 24-30.
23.	Katsumata S, Aokage K, Nakasone S, et al. Radiologic criteria in predicting pathologic less invasive lung cancer according to TNM 8th edition. Clin Lung Cancer, 2019, 20(2): e163-e170.
24.	Takahashi M, Shigematsu Y, Ohta M, et al. Tumor invasiveness as defined by the newly proposed IASLC/ATS/ERS classification has prognostic significance for pathologic stage ⅠA lung adenocarcinoma and can be predicted by radiologic parameters. J Thorac Cardiovasc Surg, 2014, 147(1): 54-59.
25.	Zhou QJ, Zheng ZC, Zhu YQ, et al. Tumor invasiveness defined by IASLC/ATS/ERS classification of ground-glass nodules can be predicted by quantitative CT parameters. J Thorac Dis, 2017, 9(5): 1190-1200.
26.	Tamura M, Matsumoto I, Saito D, et al. Mean computed tomography value to predict the tumor invasiveness in clinical stage ⅠA lung cancer. Ann Thorac Surg, 2017, 104(1): 261-266.
27.	吴汉然, 柳常青, 徐美青, 等. m-CT值在预测临床Ⅰa期肺癌和癌前病变恶性程度中的应用研究. 中国肺癌杂志, 2018, 21(3): 190-196.
28.	Kitami A, Sano F, Hayashi S, et al. Correlation between histological invasiveness and the computed tomography value in pure ground-glass nodules. Surg Today, 2016, 46(5): 593-598.
29.	Si MJ, Tao XF, Du GY, et al. Thin-section computed tomography-histopathologic comparisons of pulmonary focal interstitial fibrosis, atypical adenomatous hyperplasia, adenocarcinoma in situ, and minimally invasive adenocarcinoma with pure ground-glass opacity. Eur J Radiol, 2016, 85(10): 1708-1715.
30.	高丰, 葛虓俊, 李铭, 等. 不同病理类型肺部磨玻璃结节的CT诊断. 中华肿瘤杂志, 2014, 36(3): 188-192.
31.	Wu F, Tian SP, Jin X, et al. CT and histopathologic characteristics of lung adenocarcinoma with pure ground-glass nodules 10 mm or less in diameter. Eur Radiol, 2017, 27(10): 4037-4043.
32.	Zhan Y, Peng X, Shan F, et al. Attenuation and morphologic characteristics distinguishing a ground-glass nodule measuring 5-10 mm in diameter as invasive lung adenocarcinoma on thin-slice CT. AJR Am J Roentgenol, 2019, 213(4): W162-W170.
33.	Xiang W, Xing Y, 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(1): 33.
34.	杨越清, 高杰, 金梅, 等. 纯磨玻璃密度肺腺癌内异常空气支气管征预测病理亚型的价值. 中华放射学杂志, 2017, 51(7): 489-492.
35.	Gao F, Li M, Ge X, et al. Multi-detector spiral CT study of the relationships between pulmonary ground-glass nodules and blood vessels. Eur Radiol, 2013, 23(12): 3271-3277.
36.	Dai J, Yu G, Yu J. Can CT imaging features of ground-glass opacity predict invasiveness? A meta-analysis. Thorac Cancer, 2018, 9(4): 452-458.
37.	Son BY, Cho S, Yum SW, et al. The maximum standardized uptake value of preoperative positron emission tomography/computed tomography in lung adenocarcinoma with a ground-glass opacity component of less than 30 mm. J Surg Oncol, 2018, 117(3): 451-456.
38.	Nakamura H, Saji H, Shinmyo T, et al. Close association of IASLC/ATS/ERS lung adenocarcinoma subtypes with glucose-uptake in positron emission tomography. Lung Cancer, 2015, 87(1): 28-33.
39.	Shao X, Niu R, Jiang Z, et al. Role of PET/CT in management of early lung adenocarcinoma. AJR Am J Roentgenol, 2020, 214(2): 437-445.
40.	Fu L, Alam MS, Ren Y, et al. Utility of maximum standard uptake value as a predictor for differentiating the invasiveness of T1 stage pulmonary adenocarcinoma. Clin Lung Cancer, 2018, 19(3): 221-229.
41.	Zhou J, Li Y, Zhang Y, et al. Solitary ground-glass opacity nodules of stageⅠA pulmonary adenocarcinoma: Combination of 18F-FDG PET/CT and high-resolution computed tomography features to predict invasive adenocarcinoma. Oncotarget, 2017, 8(14): 23312-23321.
42.	Niu R, Shao X, Shao X, et al. Lung adenocarcinoma manifesting as ground-glass opacity nodules 3 cm or smaller: Evaluation with combined high-resolution CT and PET/CT modality. AJR Am J Roentgenol, 2019, 213(5): W236-W245.
43.	Lambin P, Rios-Velazquez E, Leijenaar R, et al. Radiomics: Extracting more information from medical images using advanced feature analysis. Eur J Cancer, 2012, 48(4): 441-446.
44.	Fan L, Fang M, Li Z, et al. Radiomics signature: A biomarker for the preoperative discrimination of lung invasive adenocarcinoma manifesting as a ground-glass nodule. Eur Radiol, 2019, 29(2): 889-897.
45.	范丽, 方梦捷, 董迪, 等. 影像组学对磨玻璃结节型肺腺癌病理亚型的预测效能. 中华放射学杂志, 2017, 51(12): 912-917.
46.	Liu CL, Zhang F, Cai Q, et al. Establishment of a predictive model for surgical resection of ground-glass nodules. J Am Coll Radiol, 2019, 16(4 Pt A): 435-445.
47.	Sun Y, Li C, Jin L, et al. Radiomics for lung adenocarcinoma manifesting as pure ground-glass nodules: Invasive prediction. Eur Radiol, 2020, 30(7): 3650-3659.
48.	张鹏, 徐欣楠, 王洪伟, 等. 基于深度学习的计算机辅助肺癌诊断方法. 计算机辅助设计与图形学学报, 2018, 30(1): 90-99.
49.	Wang S, Wang R, Zhang S, et al. 3D convolutional neural network for differentiating pre-invasive lesions from invasive adenocarcinomas appearing as ground-glass nodules with diameters≤3 cm using HRCT. Quant Imaging Med Surg, 2018, 8(5): 491-499.
50.	Ni Y, Yang Y, Zheng D, et al. The invasiveness classification of ground-glass nodules using 3D attention network and HRCT. J Digit Imaging, 2020, 33(5): 1144-1154.
51.	Kobayashi Y, Mitsudomi T, Sakao Y, et al. Genetic features of pulmonary adenocarcinoma presenting with ground-glass nodules: The differences between nodules with and without growth. Ann Oncol, 2015, 26(1): 156-161.
52.	Zou J, Lv T, Zhu S, et al. Computed tomography and clinical features associated with epidermal growth factor receptor mutation status in stage Ⅰ/Ⅱ lung adenocarcinoma. Thorac Cancer, 2017, 8(3): 260-270.
53.	Hong SJ, Kim TJ, Choi YW, et al. Radiogenomic correlation in lung adenocarcinoma with epidermal growth factor receptor mutations: Imaging features and histological subtypes. Eur Radiol, 2016, 26(10): 3660-3668.
54.	Rizzo S, Petrella F, Buscarino V, et al. CT radiogenomic characterization of EGFR, K-RAS, and ALK mutations in non-small cell lung cancer. Eur Radiol, 2016, 26(1): 32-42.
55.	Lee HJ, Kim YT, Kang CH, et al. Epidermal growth factor receptor mutation in lung adenocarcinomas: Relationship with CT characteristics and histologic subtypes. Radiology, 2013, 268(1): 254-264.
56.	Glynn C, Zakowski MF, Ginsberg MS. Are there imaging characteristics associated with epidermal growth factor receptor and KRAS mutations in patients with adenocarcinoma of the lung with bronchioloalveolar features? J Thorac Oncol, 2010, 5(3): 344-348.
57.	Dai J, Shi J, Soodeen-Lalloo AK, et al. Air bronchogram: A potential indicator of epidermal growth factor receptor mutation in pulmonary subsolid nodules. Lung Cancer, 2016, 98: 22-28.
58.	Hsu JS, Huang MS, Chen CY, et al. Correlation between EGFR mutation status and computed tomography features in patients with advanced pulmonary adenocarcinoma. J Thorac Imaging, 2014, 29(6): 357-363.
59.	Li X, Zhang W, Yu Y, et al. CT features and quantitative analysis of subsolid nodule lung adenocarcinoma for pathological classification prediction. BMC Cancer, 2020, 20(1): 60.
60.	姜格宁, 陈昶, 朱余明, 等. 上海市肺科医院磨玻璃结节早期肺腺癌的诊疗共识(第一版). 中国肺癌杂志, 2018, 21(3): 147-159.

1. The International Agency for Research on Cancer. World cancer report: Cancer research for cancer prevention. URL: https://www.iarc.who.int/featured-news/new-world-cancer-report/. (2020-02-04) [2022-03-10].
2. 李媛, 谢惠康, 武春燕. WHO胸部肿瘤分类(第5版)中肺肿瘤部分解读. 中国癌症杂志, 2021, 31(7): 574-580.
3. Xinli W, Xiaoshuang S, Chengxin Y, et al. CT-assisted improvements in the accuracy of the intraoperative frozen section examination of ground-glass density nodules. Comput Math Methods Med, 2022, 2022: 8967643.
4. Yotsukura M, Asamura H, Motoi N, et al. Long-term prognosis of patients with resected adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung. J Thorac Oncol, 2021, 16(8): 1312-1320.
5. Watanabe Y, Hattori A, Nojiri S, et al. Clinical impact of a small component of ground-glass opacity in solid-dominant clinical stage ⅠA non-small cell lung cancer. J Thorac Cardiovasc Surg, 2022, 163(3): 791-801.
6. Suzuki K, Watanabe SI, Wakabayashi M, et al. A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer. J Thorac Cardiovasc Surg, 2022, 163(1): 289-301.
7. Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
8. Zhang Y, Shen Y, Qiang JW, et al. HRCT features distinguishing pre-invasive from invasive pulmonary adenocarcinomas appearing as ground-glass nodules. Eur Radiol, 2016, 26(9): 2921-2928.
9. Han L, Zhang P, Wang Y, et al. CT quantitative parameters to predict the invasiveness of lung pure ground-glass nodules (pGGNs). Clin Radiol, 2018, 73(5): 504.e1-504.e7.
10. Chu ZG, Li WJ, Fu BJ, et al. CT characteristics for predicting invasiveness in pulmonary pure ground-glass nodules. AJR Am J Roentgenol, 2020, 215(2): 351-358.
11. Fu F, Zhang Y, Wang S, et al. Computed tomography density is not associated with pathological tumor invasion for pure ground-glass nodules. J Thorac Cardiovasc Surg, 2021, 162(2): 451-459.
12. Liu LH, Liu M, Wei R, et al. CT findings of persistent pure ground glass opacity: Can we predict the invasiveness? Asian Pac J Cancer Prev, 2015, 16(5): 1925-1928.
13. Lee SM, Park CM, Goo JM, et al. Invasive pulmonary adenocarcinomas versus preinvasive lesions appearing as ground-glass nodules: Differentiation by using CT features. Radiology, 2013, 268(1): 265-273.
14. Lim HJ, Ahn S, Lee KS, et al. Persistent pure ground-glass opacity lung nodules≥10 mm in diameter at CT scan: Histopathologic comparisons and prognostic implications. Chest, 2013, 144(4): 1291-1299.
15. Li Q, Gu YF, Fan L, et al. Effect of CT window settings on size measurements of the solid component in subsolid nodules: Evaluation of prediction efficacy of the degree of pathological malignancy in lung adenocarcinoma. Br J Radiol, 2018, 91(1088): 20180251.
16. Yoo RE, Goo JM, Hwang EJ, et al. Retrospective assessment of interobserver agreement and accuracy in classifications and measurements in subsolid nodules with solid components less than 8 mm: Which window setting is better? Eur Radiol, 2017, 27(4): 1369-1376.
17. Lee KH, Goo JM, Park SJ, et al. Correlation between the size of the solid component on thin-section CT and the invasive component on pathology in small lung adenocarcinomas manifesting as ground-glass nodules. J Thorac Oncol, 2014, 9(1): 74-82.
18. Cohen JG, Reymond E, Lederlin M, et al. Differentiating pre- and minimally invasive from invasive adenocarcinoma using CT-features in persistent pulmonary part-solid nodules in Caucasian patients. Eur J Radiol, 2015, 84(4): 738-744.
19. Vansteenkiste JF, Cho BC, Vanakesa T, et al. Efficacy of the MAGE-A3 cancer immunotherapeutic as adjuvant therapy in patients with resected MAGE-A3-positive non-small-cell lung cancer (MAGRIT): A randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol, 2016, 17(6): 822-835.
20. Liang J, Xu XQ, Xu H, et al. Using the CT features to differentiate invasive pulmonary adenocarcinoma from pre-invasive lesion appearing as pure or mixed ground-glass nodules. Br J Radiol, 2015, 88(1053): 20140811.
21. Suzuki K, Koike T, Asakawa T, et al. A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical ⅠA lung cancer (Japan Clinical Oncology Group 0201). J Thorac Oncol, 2011, 6(4): 751-756.
22. Asamura H, Hishida T, Suzuki K, et al. Radiographically determined noninvasive adenocarcinoma of the lung: Survival outcomes of Japan Clinical Oncology Group 0201. J Thorac Cardiovasc Surg, 2013, 146(1): 24-30.
23. Katsumata S, Aokage K, Nakasone S, et al. Radiologic criteria in predicting pathologic less invasive lung cancer according to TNM 8th edition. Clin Lung Cancer, 2019, 20(2): e163-e170.
24. Takahashi M, Shigematsu Y, Ohta M, et al. Tumor invasiveness as defined by the newly proposed IASLC/ATS/ERS classification has prognostic significance for pathologic stage ⅠA lung adenocarcinoma and can be predicted by radiologic parameters. J Thorac Cardiovasc Surg, 2014, 147(1): 54-59.
25. Zhou QJ, Zheng ZC, Zhu YQ, et al. Tumor invasiveness defined by IASLC/ATS/ERS classification of ground-glass nodules can be predicted by quantitative CT parameters. J Thorac Dis, 2017, 9(5): 1190-1200.
26. Tamura M, Matsumoto I, Saito D, et al. Mean computed tomography value to predict the tumor invasiveness in clinical stage ⅠA lung cancer. Ann Thorac Surg, 2017, 104(1): 261-266.
27. 吴汉然, 柳常青, 徐美青, 等. m-CT值在预测临床Ⅰa期肺癌和癌前病变恶性程度中的应用研究. 中国肺癌杂志, 2018, 21(3): 190-196.
28. Kitami A, Sano F, Hayashi S, et al. Correlation between histological invasiveness and the computed tomography value in pure ground-glass nodules. Surg Today, 2016, 46(5): 593-598.
29. Si MJ, Tao XF, Du GY, et al. Thin-section computed tomography-histopathologic comparisons of pulmonary focal interstitial fibrosis, atypical adenomatous hyperplasia, adenocarcinoma in situ, and minimally invasive adenocarcinoma with pure ground-glass opacity. Eur J Radiol, 2016, 85(10): 1708-1715.
30. 高丰, 葛虓俊, 李铭, 等. 不同病理类型肺部磨玻璃结节的CT诊断. 中华肿瘤杂志, 2014, 36(3): 188-192.
31. Wu F, Tian SP, Jin X, et al. CT and histopathologic characteristics of lung adenocarcinoma with pure ground-glass nodules 10 mm or less in diameter. Eur Radiol, 2017, 27(10): 4037-4043.
32. Zhan Y, Peng X, Shan F, et al. Attenuation and morphologic characteristics distinguishing a ground-glass nodule measuring 5-10 mm in diameter as invasive lung adenocarcinoma on thin-slice CT. AJR Am J Roentgenol, 2019, 213(4): W162-W170.
33. Xiang W, Xing Y, 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(1): 33.
34. 杨越清, 高杰, 金梅, 等. 纯磨玻璃密度肺腺癌内异常空气支气管征预测病理亚型的价值. 中华放射学杂志, 2017, 51(7): 489-492.
35. Gao F, Li M, Ge X, et al. Multi-detector spiral CT study of the relationships between pulmonary ground-glass nodules and blood vessels. Eur Radiol, 2013, 23(12): 3271-3277.
36. Dai J, Yu G, Yu J. Can CT imaging features of ground-glass opacity predict invasiveness? A meta-analysis. Thorac Cancer, 2018, 9(4): 452-458.
37. Son BY, Cho S, Yum SW, et al. The maximum standardized uptake value of preoperative positron emission tomography/computed tomography in lung adenocarcinoma with a ground-glass opacity component of less than 30 mm. J Surg Oncol, 2018, 117(3): 451-456.
38. Nakamura H, Saji H, Shinmyo T, et al. Close association of IASLC/ATS/ERS lung adenocarcinoma subtypes with glucose-uptake in positron emission tomography. Lung Cancer, 2015, 87(1): 28-33.
39. Shao X, Niu R, Jiang Z, et al. Role of PET/CT in management of early lung adenocarcinoma. AJR Am J Roentgenol, 2020, 214(2): 437-445.
40. Fu L, Alam MS, Ren Y, et al. Utility of maximum standard uptake value as a predictor for differentiating the invasiveness of T1 stage pulmonary adenocarcinoma. Clin Lung Cancer, 2018, 19(3): 221-229.
41. Zhou J, Li Y, Zhang Y, et al. Solitary ground-glass opacity nodules of stageⅠA pulmonary adenocarcinoma: Combination of 18F-FDG PET/CT and high-resolution computed tomography features to predict invasive adenocarcinoma. Oncotarget, 2017, 8(14): 23312-23321.
42. Niu R, Shao X, Shao X, et al. Lung adenocarcinoma manifesting as ground-glass opacity nodules 3 cm or smaller: Evaluation with combined high-resolution CT and PET/CT modality. AJR Am J Roentgenol, 2019, 213(5): W236-W245.
43. Lambin P, Rios-Velazquez E, Leijenaar R, et al. Radiomics: Extracting more information from medical images using advanced feature analysis. Eur J Cancer, 2012, 48(4): 441-446.
44. Fan L, Fang M, Li Z, et al. Radiomics signature: A biomarker for the preoperative discrimination of lung invasive adenocarcinoma manifesting as a ground-glass nodule. Eur Radiol, 2019, 29(2): 889-897.
45. 范丽, 方梦捷, 董迪, 等. 影像组学对磨玻璃结节型肺腺癌病理亚型的预测效能. 中华放射学杂志, 2017, 51(12): 912-917.
46. Liu CL, Zhang F, Cai Q, et al. Establishment of a predictive model for surgical resection of ground-glass nodules. J Am Coll Radiol, 2019, 16(4 Pt A): 435-445.
47. Sun Y, Li C, Jin L, et al. Radiomics for lung adenocarcinoma manifesting as pure ground-glass nodules: Invasive prediction. Eur Radiol, 2020, 30(7): 3650-3659.
48. 张鹏, 徐欣楠, 王洪伟, 等. 基于深度学习的计算机辅助肺癌诊断方法. 计算机辅助设计与图形学学报, 2018, 30(1): 90-99.
49. Wang S, Wang R, Zhang S, et al. 3D convolutional neural network for differentiating pre-invasive lesions from invasive adenocarcinomas appearing as ground-glass nodules with diameters≤3 cm using HRCT. Quant Imaging Med Surg, 2018, 8(5): 491-499.
50. Ni Y, Yang Y, Zheng D, et al. The invasiveness classification of ground-glass nodules using 3D attention network and HRCT. J Digit Imaging, 2020, 33(5): 1144-1154.
51. Kobayashi Y, Mitsudomi T, Sakao Y, et al. Genetic features of pulmonary adenocarcinoma presenting with ground-glass nodules: The differences between nodules with and without growth. Ann Oncol, 2015, 26(1): 156-161.
52. Zou J, Lv T, Zhu S, et al. Computed tomography and clinical features associated with epidermal growth factor receptor mutation status in stage Ⅰ/Ⅱ lung adenocarcinoma. Thorac Cancer, 2017, 8(3): 260-270.
53. Hong SJ, Kim TJ, Choi YW, et al. Radiogenomic correlation in lung adenocarcinoma with epidermal growth factor receptor mutations: Imaging features and histological subtypes. Eur Radiol, 2016, 26(10): 3660-3668.
54. Rizzo S, Petrella F, Buscarino V, et al. CT radiogenomic characterization of EGFR, K-RAS, and ALK mutations in non-small cell lung cancer. Eur Radiol, 2016, 26(1): 32-42.
55. Lee HJ, Kim YT, Kang CH, et al. Epidermal growth factor receptor mutation in lung adenocarcinomas: Relationship with CT characteristics and histologic subtypes. Radiology, 2013, 268(1): 254-264.
56. Glynn C, Zakowski MF, Ginsberg MS. Are there imaging characteristics associated with epidermal growth factor receptor and KRAS mutations in patients with adenocarcinoma of the lung with bronchioloalveolar features? J Thorac Oncol, 2010, 5(3): 344-348.
57. Dai J, Shi J, Soodeen-Lalloo AK, et al. Air bronchogram: A potential indicator of epidermal growth factor receptor mutation in pulmonary subsolid nodules. Lung Cancer, 2016, 98: 22-28.
58. Hsu JS, Huang MS, Chen CY, et al. Correlation between EGFR mutation status and computed tomography features in patients with advanced pulmonary adenocarcinoma. J Thorac Imaging, 2014, 29(6): 357-363.
59. Li X, Zhang W, Yu Y, et al. CT features and quantitative analysis of subsolid nodule lung adenocarcinoma for pathological classification prediction. BMC Cancer, 2020, 20(1): 60.
60. 姜格宁, 陈昶, 朱余明, 等. 上海市肺科医院磨玻璃结节早期肺腺癌的诊疗共识(第一版). 中国肺癌杂志, 2018, 21(3): 147-159.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Research progress on the correlation between imaging characteristics and pathological invasion degree of early lung adenocarcinoma

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