The following is a summary of the “Prospective Radiologic-Pathologic Correlation of Macroscopic Volume and Microscopic Extension of Nonsolid Lung Nodules on Thin-section CT Images for Sublobar Resection and Stereotactic Radiotherapy Planning,” published in the March 2023 issue of Clinical Lung Cancer by Beddok, et al.

The purpose of this research was to evaluate the potential utility of computed tomography (CT) in the planning, surgery, or stereotactic body radiation therapy (SBRT) of nonsolid lung nodules (NSNs) by measuring their macroscopic and microscopic extension. In 2020/21, 23 patients with NSN and a ground-glass component of more than 50% were prospectively included in the study at the Foch Hospital. First, CT and pathologic measurements of the NSN’s macroscopic dimensions were taken for each patient. 

Second, pathologic analysis was used to evaluate microscopic spread. These comparisons were made using Wilcoxon signed-rank tests. Finally, the degree of concordance between radiologic and pathologic measurements was analyzed using the Spearman correlation test and the Bland-Altman method. The median largest diameter and volume of NSN on CT were 21 millimeters and 3,780 cc, respectively, while these values were 15 millimeters and 1,800 cc upon pathologic examination. As a result, CT demonstrated a larger diameter and volume for the NSN than the pathological analysis. 

The median largest diameter and volume of NSN for microscopic extension were 17 millimeters and 2,040 cubic centimeters, respectively. There was no discernible disconnect between the gross appearance and the underlying microscopic structure during the pathological examination. Furthermore, Bland-Altman plots and correlation analyses demonstrated that radiologic and pathologic measurements could yield comparable precision. Through this research, we established that CT is suitable for use in NSN treatment planning, as it did not underestimate either the macroscopic size or the microscopic extension of the disease.

Source: sciencedirect.com/science/article/abs/pii/S1525730422002431