ArticleCancer imaging : the official publication of the International Cancer Imaging Society2025
CT feature-based nomogram for predicting tumor spread through air spaces in stage IA lung adenocarcinoma.
Article in Cancer imaging : the official publication of the International Cancer Imaging Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Spectral CT-based intratumoral and peritumoral radiomics for predicting invasiveness of ground-glass nodules in lung adenocarcinoma.La Radiologia medica · 2026Article
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6 authors.
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Abstract
objectivesThis research aimed to examine the relationships between clinicopathological characteristics and the occurrence of Spread Through Air Spaces (STAS) in patients with stage IA lung adenocarcinoma (LUAD) and to develop a preoperative prediction model.
methodsData from 1,375 patients with stage IA LUAD at Sun Yat-sen University Cancer Center were analyzed. Propensity score matching (PSM) was employed to match 141 STAS-positive patients with 282 STAS-negative patients. Both univariate and multivariate logistic regression analyses were performed to determine independent variables among 16 clinicopathological and 13 CT imaging characteristics. A nomogram prediction model was developed and evaluated via receiver operating characteristic (ROC) and decision curve analyses (DCAs).
resultsMultivariate analysis identified several independent risk factors. Irregular nodule shape (OR = 1.817, 95% CI: 1.106-2.986, p = 0.018), irregular margin (OR = 2.050, 95% CI: 1.218-3.449, p = 0.007), lobulation (OR = 2.235, 95% CI: 1.336-3.739, p = 0.002), and vascular convergence (OR = 5.032, 95% CI: 2.050-12.349, p < 0.001) were significantly associated with an increased risk of STAS. Compared with a consolidation tumor ratio (CTR) = 0% (reference), a CTR of 75-100% (OR = 7.086, 95% CI: 2.542-19.750, p < 0.001) and a CTR = 100% (OR = 11.502, 95% CI: 4.752-27.840, p < 0.001) were significantly associated with an increased risk of STAS. The nomogram was developed and internally validated, demonstrating good predictive accuracy (AUC = 0.812, 95% CI: 0.761-0.863) and favorable clinical utility, with a sensitivity of 69.5% and a specificity of 80.2%.
conclusionThe nomogram reliably predicts STAS preoperatively and may assist in guiding surgical decision-making.
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