Qualitative and Quantitative Computed Tomography Analyses of Lung Adenocarcinoma for Predicting Spread Through Air Spaces

Background/Objectives: Spread through air spaces (STAS) is defined as the spread of tumor cells into the parenchymal alveolar space beyond the margins of the main tumor, and it is associated with worse clinical outcomes in resected lung adenocarcinoma. This study aimed to evaluate the preoperative c...

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Main Authors: Fumi Kameda, Yoshie Kunihiro, Masahiro Tanabe, Masatoshi Nakashima, Taiga Kobayashi, Toshiki Tanaka, Yoshinobu Hoshii, Katsuyoshi Ito
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Tomography
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Online Access:https://www.mdpi.com/2379-139X/11/7/76
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author Fumi Kameda
Yoshie Kunihiro
Masahiro Tanabe
Masatoshi Nakashima
Taiga Kobayashi
Toshiki Tanaka
Yoshinobu Hoshii
Katsuyoshi Ito
author_facet Fumi Kameda
Yoshie Kunihiro
Masahiro Tanabe
Masatoshi Nakashima
Taiga Kobayashi
Toshiki Tanaka
Yoshinobu Hoshii
Katsuyoshi Ito
author_sort Fumi Kameda
collection DOAJ
description Background/Objectives: Spread through air spaces (STAS) is defined as the spread of tumor cells into the parenchymal alveolar space beyond the margins of the main tumor, and it is associated with worse clinical outcomes in resected lung adenocarcinoma. This study aimed to evaluate the preoperative computed tomography (CT) findings of primary lung adenocarcinoma in surgically resected T1 cases and to compare CT findings with and without STAS. Methods: A total of 145 patients were included in this study. The following factors were evaluated on CT images: nodule type (pure ground-glass nodule [GGN], part-solid nodule, or solid nodule), margin (smooth or irregular), the presence of lobulation, spicula, cavity, calcification, central low attenuation, peripheral opacity (well-defined or ill-defined), air bronchogram, satellite lesions, pleural retraction, pulmonary emphysema, and interstitial pneumonia; CT values (maximum, minimum, and mean); volume (tumor and solid component); and diameter (tumor and solid component). CT criteria were compared between the presence and absence of STAS. Results: Lobulation and central low attenuation were significantly more frequent in patients with STAS (<i>p</i> < 0.05). The mean CT value, and the volume, rate, and diameter of the solid component were significantly larger in cases with STAS (<i>p</i> < 0.05). A multiple logistic regression analysis identified central low attenuation as an indicator of the presence of STAS (<i>p</i> < 0.001; odds ratio, 3.993; 95% confidence interval, 1.993–8.001). Conclusions: Quantitative and qualitative analyses are useful for differentiating between the presence and absence of STAS.
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spelling doaj-art-a251527a4c564dc08f66b3f99eb00bc32025-08-20T03:32:35ZengMDPI AGTomography2379-13812379-139X2025-06-011177610.3390/tomography11070076Qualitative and Quantitative Computed Tomography Analyses of Lung Adenocarcinoma for Predicting Spread Through Air SpacesFumi Kameda0Yoshie Kunihiro1Masahiro Tanabe2Masatoshi Nakashima3Taiga Kobayashi4Toshiki Tanaka5Yoshinobu Hoshii6Katsuyoshi Ito7Department of Radiology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, JapanDepartment of Radiology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, JapanDepartment of Radiology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, JapanDepartment of Radiology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, JapanDepartment of Radiology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, JapanDepartment of Surgery and Clinical Science, Division of Chest Surgery, Yamaguchi University Graduate School of Medicine, Ube 755-8505, JapanDepartment of Diagnostic Pathology, Yamaguchi University Hospital, Ube 755-8505, JapanDepartment of Radiology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, JapanBackground/Objectives: Spread through air spaces (STAS) is defined as the spread of tumor cells into the parenchymal alveolar space beyond the margins of the main tumor, and it is associated with worse clinical outcomes in resected lung adenocarcinoma. This study aimed to evaluate the preoperative computed tomography (CT) findings of primary lung adenocarcinoma in surgically resected T1 cases and to compare CT findings with and without STAS. Methods: A total of 145 patients were included in this study. The following factors were evaluated on CT images: nodule type (pure ground-glass nodule [GGN], part-solid nodule, or solid nodule), margin (smooth or irregular), the presence of lobulation, spicula, cavity, calcification, central low attenuation, peripheral opacity (well-defined or ill-defined), air bronchogram, satellite lesions, pleural retraction, pulmonary emphysema, and interstitial pneumonia; CT values (maximum, minimum, and mean); volume (tumor and solid component); and diameter (tumor and solid component). CT criteria were compared between the presence and absence of STAS. Results: Lobulation and central low attenuation were significantly more frequent in patients with STAS (<i>p</i> < 0.05). The mean CT value, and the volume, rate, and diameter of the solid component were significantly larger in cases with STAS (<i>p</i> < 0.05). A multiple logistic regression analysis identified central low attenuation as an indicator of the presence of STAS (<i>p</i> < 0.001; odds ratio, 3.993; 95% confidence interval, 1.993–8.001). Conclusions: Quantitative and qualitative analyses are useful for differentiating between the presence and absence of STAS.https://www.mdpi.com/2379-139X/11/7/76spread through air spacesX-ray-computed tomographylung adenocarcinomaquantitative analysismultivariate analysis
spellingShingle Fumi Kameda
Yoshie Kunihiro
Masahiro Tanabe
Masatoshi Nakashima
Taiga Kobayashi
Toshiki Tanaka
Yoshinobu Hoshii
Katsuyoshi Ito
Qualitative and Quantitative Computed Tomography Analyses of Lung Adenocarcinoma for Predicting Spread Through Air Spaces
Tomography
spread through air spaces
X-ray-computed tomography
lung adenocarcinoma
quantitative analysis
multivariate analysis
title Qualitative and Quantitative Computed Tomography Analyses of Lung Adenocarcinoma for Predicting Spread Through Air Spaces
title_full Qualitative and Quantitative Computed Tomography Analyses of Lung Adenocarcinoma for Predicting Spread Through Air Spaces
title_fullStr Qualitative and Quantitative Computed Tomography Analyses of Lung Adenocarcinoma for Predicting Spread Through Air Spaces
title_full_unstemmed Qualitative and Quantitative Computed Tomography Analyses of Lung Adenocarcinoma for Predicting Spread Through Air Spaces
title_short Qualitative and Quantitative Computed Tomography Analyses of Lung Adenocarcinoma for Predicting Spread Through Air Spaces
title_sort qualitative and quantitative computed tomography analyses of lung adenocarcinoma for predicting spread through air spaces
topic spread through air spaces
X-ray-computed tomography
lung adenocarcinoma
quantitative analysis
multivariate analysis
url https://www.mdpi.com/2379-139X/11/7/76
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