Computed tomographic features of pulmonary pure ground-glass nodule: a comparison between neoplastic and non-neoplastic nodules

Abstract

Abstract Background Ground-glass nodules (GGNs) are detected more frequently nowadays with the increase in MDCT resolution and applications. On CT GGN is a well circumscribed nodule with mild increase attenuation and not obscuring bronchial and vascular markings. This study aimed to discriminate neoplastic from non-neoplastic pure ground-glass nodules (pGGNs) by performing comparative quantitative and qualitative assessment of main features in computed tomography (CT) chest imaging. This prospective study involved 72 patients, who were referred to perform multidetector computed tomography of the chest in the radiology department. Cases with ground-glass pulmonary nodules were included in the study, and each nodule was assessed and followed for 2 years by a radiomics software for density and histogram analysis and then classified to neoplastic and non-neoplastic nodules. Neoplastic and non-neoplastic nodules morphology and radiomics were compared, and statistical analysis was done. Results After histopathology, positron emission tomography and computed tomography, or close follow-up, pGGNs were classified to neoplastic and non-neoplastic nodules. There was statistically significant difference regarding the mean size, where in cases of neoplastic nodules it was 6.66 mm and the mean size of benign nodules was 11.25 mm. Moreover, irregularity index and histogram peak frequency had a significant correlation with a P value of 0.007 and 0.022, respectively. The cutoff level for peak frequency percentage was 20.5% with 56.3% sensitivity and 79.2% specificity. Conclusions Radiomics had a growing role in pulmonary nodule assessment. Radiomics along with morphologic features assessment improved the detection efficiency of neoplastic versus non-neoplastic ground-glass nodules with histogram peak frequency, nodule size, and irregularity index as the main differentiating factors in this study.