中国肺癌杂志2016，Vol.19Issue(5)：279-285,7.DOI:10.3779/j.issn.1009-3419.2016.05.05
CT三维容积分析在实性肺结节恶性风险度评估中的价值
Three Dimensional Volumetric Analysis of Solid Pulmonary Nodules on Chest CT：Cancer Risk Assessment
摘要
Abstract
Background and objective hTe management of pulmonary nodules relies on cancer risk assessment, in which the only widely accepted criterion is diameter. hTe development of volumetric computed tomography (CT) and three-dimensional (3D) sotfware enhances the clarity in displaying the nodules’ characteristics. hTis study evaluated the values of the nodules’ volume and 3D morphological characteristics (edge, shape and location) in cancer risk assessment.Methods hTe CT data of 200 pulmonary nodules were retrospectively evaluated using 3D volumetric sotfware. hTe malignancy or benignity of all the nodules was conifrmed by pathology, histology or follow up (>2 years).Logistic regression analysis was performed to calculate the odds ratios (ORs) of the 3D margin (smooth, lobulated or spiculated/irregular), shape (spherical or non-spherical), location (purely intraparenchymal, juxtavascular or pleural-attached), and nodule volume in cancer risk assessment for total and sub-centimeter nodules. hTe receiver operating characteristic (ROC) curve was employed to determine the opti-mal threshold for the nodule volume.Results Out of 200 pulmonary nodules, 78 were malignant, whereas 122 were benign. hTeLogistic regression analysis showed that the volume (OR=3.3;P<0.001) and the 3D margin (OR=13.4, 9.8; bothP=0.001) were independent predictive factors of malignancy, whereas the location and 3D shape exhibited no total predictive value (P>0.05). ROC analysis showed that the optimal threshold for malignancy was 666 mm³. For sub-centimeter nodules, the 3D margin was the only valuable predictive factor of malignancy (OR=60.5, 75.0;P=0.003, 0.007).Conclusion hTe volume and 3D margin are important factors considered to assess the cancer risk of pulmonary nodules. Volumes larger than 666 mm³ can be determined as high risk for pulmonary nodules; by contrast, nodules with lobulated, spiculated, or irregular margin present a high malignancy probability.关键词
肺结节/计算机体层摄影/容积/三维形态分析/风险度Key words
Pulmonary nodules/Computed tomography/Volume/hTree-dimensional volumetric analysis/Can-cer risk assessment引用本文复制引用
李梦琦,韩融城,宋文静,王欣悦,郭芳芳,苏大同,于铁链,王颖..CT三维容积分析在实性肺结节恶性风险度评估中的价值[J].中国肺癌杂志,2016,19(5):279-285,7.基金项目
本研究受国家自然科学基金面上项目（No.81171345）、中央补助地方公共卫生专项资金肺癌早诊早治项目和2012年高等学校博士学科点专项科研基金（No.20121202110005）资助@@@@This study was supported by the grants from the National Natural Science Foundation of China (to Ying WANG)(No.81171345), Lung Cancer Early Detection and Treatment Project Funded by the Public Health Special Subsidy from the Central Government and Research Fund for the Doctoral Program of Higher Education of China (both to Tielian YU)(No.20121202110005) （to Ying WANG）
