Abstract
Background
Pulmonary adenocarcinoma, a predominant form of lung cancer, is characterized by diverse histopathological subtypes, including ground-glass nodules (GGNs), which may represent different degrees of malignancy. The accurate differentiation between invasive and non-invasive GGNs is paramount, as it significantly influences clinical management and treatment strategies.
Objective
To evaluate the clinical efficacy of spectral CT combined with targeted scanning in diagnosing invasive GGNs in pulmonary adenocarcinoma.
Methods
A retrospective analysis of 120 patients with GGNs, who underwent spectral CT and targeted scanning at the Second Affiliated Hospital of Qiqihar Medical College (Nov 2021 - Dec 2022), was conducted. Patients were categorized based on postoperative pathology into non-invasive (66) and invasive (54) groups. Imaging features and values of various indicators including water concentration (WC), spectral curve slope (k value), and iodine concentration across different phases were analyzed and compared. Key independent factors for invasive GGN and the predictive value of the combined imaging technique were explored.
Results
The invasive lesion group showed a higher incidence of fissure sign, spiculation sign, and bronchial inflation sign, along with increased values of WC, WCAP, and WCVP across phases (p < 0.05). These factors were identified as main influencers of invasive GGN, with OR values >1. The combined imaging parameters achieved an AUC of 0.914, sensitivity of 0.925, and specificity of 0.880, significantly outperforming individual indicators.
Conclusion
Fissure sign, spiculation sign, bronchial inflation sign, WC, WCAP, and WCVP effectively predict invasive GGNs in pulmonary adenocarcinoma. Their combined application enhances predictive accuracy.
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