ArticleThoracic cancer2020
Clinical T category for lung cancer staging: A pragmatic approach for real-world practice.
Article in Thoracic cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Proper clinical and pathologic T stage among diverse T descriptors in terms of recurrence after curative surgery for stage I lung adenocarcinoma.Journal of thoracic disease · 2025Article
- Lung Cancer Staging: Imaging and Potential Pitfalls.Diagnostics (Basel, Switzerland) · 2023Review
- Predicting the pathological invasiveness of early lung adenocarcinoma prior to surgery using Deauville criteria: reliability and validity.Japanese journal of radiology · 2023Article
- Potential of artificial intelligence based on chest computed tomography to predict the nature of part-solid nodules.The clinical respiratory journal · 2023Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundTo determine which components should be measured and which window settings are appropriate for computerized tomography (CT) size measurements of lung adenocarcinoma (ADC) and to explore interobserver agreement and accuracy according to the eighth edition of TNM staging.
methodsA total of 165 patients with surgically resected lung ADC earlier than stage 3A were included in this study. One radiologist and two pulmonologists independently measured the total and solid sizes of components of tumors on different window settings and assessed solidity. CT measurements were compared with pathologic size measurements.
resultsIn categorizing solidity, 25% of the cases showed discordant results among observers. Measuring the total size of a lung adenocarcinoma predicted pathologic invasive components to a degree similar to measuring the solid component. Lung windows were more accurate (intraclass correlation [ICC] = 0.65-0.81) than mediastinal windows (ICC = 0.20-0.72) at predicting pathologic invasive components, especially in a part-solid nodule. Interobserver agreements for measurement of solid components were good with little significant difference (lung windows, ICC = 0.89; mediastinal windows, ICC = 0.91). A high level of interobserver agreement was seen between the radiologist and pulmonologists and between residents (from the division of pulmonology and critical care) versus a fellow (from the division of pulmonology and critical care) on different windows.
conclusionsA considerable percentage (25%) of discrepancies was encountered in categorizing the solidity of lesions, which may decrease the accuracy of measurements. Lung window settings may be superior to mediastinal windows for measuring lung ADCs, with comparable interobserver agreement and moderate accuracy for predicting pathologic invasive components. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: Lung window settings are better for evaluating part-solid lung adenocarcinoma (ADC), with comparable interobserver agreement and moderate accuracy for predicting pathologic invasive components. The considerable percentage (25%) of discrepancies in categorizing solidity of the lesions may also have decreased the accuracy of measurements. WHAT THIS STUDY ADDS: For accurate measurement and categorization of lung ADC, robust quantitative analysis is needed rather than a simple visual assessment.
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