Mean computed tomography Value to predict Spread through air spaces in clinical N0 lung adenocarcinoma

Abstract

Abstract Background The aim of this study was to assess the ability of radiologic factors such as mean computed tomography (mCT) value, consolidation/tumor ratio (C/T ratio), solid tumor size, and standardized uptake (SUV) value to predict the presence of spread through air spaces (STAS) of lung adenocarcinoma.Methods A retrospective study was conducted on 118 patients those diagnosed with clinically without lymph node metastasis and having a pathological diagnosis of adenocarcinoma after undergoing surgery. Receiver operating characteristics (ROC) analysis was used to assess the ability to use mCT value, C/T ratio, tumor size, and SUV to predict STAS. Univariate and multiple logistic regression analyses were performed to determine the independent variables for the prediction of STAS.Results Forty-one lesions (34.7%) were positive for STAS and 77 lesions were negative for STAS. The STAS positive group was strongly associated with a high mCT value, high C/T ratio, large solid tumor size, large tumor size and high SUV. The mCT values were − 324.9 ± 19.3 HU for STAS negative group and − 173.0 ± 26.3 HU for STAS positive group (p < 0.0001). The ROC area under the curve value of the mCT value was the highest (0.738), followed by SUV (0.720), C/T ratio (0.665), solid tumor size (0.649). Multiple logistic regression analyses using the preoperatively determined variables revealed that mCT value (p = 0.013) was independent predictive factors of predicting STAS. The maximum sensitivity and specificity were obtained at a cutoff value of -251.8 HU.Conclusions The evaluation of mCT value was useful for predicting the presence of STAS and may potentially contribute to the selection of suitable treatment strategies.