Value of multi-planar volume reconstructions in evaluating the aggressiveness of lung ground glass nodules

Zhang Ke; Jing Weiwei; Li Dan; Luo Renjun; Tong Liang; Zhang Yundan; Lü Fajin

doi:10.13406/j.cnki.cyxb.003740

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Value of multi-planar volume reconstructions in evaluating the aggressiveness of lung ground glass nodules

Precision medicine in cancer and translational studies | 更新时间：2025-12-31

- Value of multi-planar volume reconstructions in evaluating the aggressiveness of lung ground glass nodules
- Journal of Chongqing Medical University Vol. 50, Issue 12, Pages: 1656-1661(2025)
- 作者机构：
  
  1.重庆医科大学附属第一医院放射科，重庆 400016
  2.重庆医科大学附属第一医院病理科，重庆 400016
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003740
  CLC： R734.2
- Received：04 July 2024，
  
  Revised：2024-12-25，
  
  Accepted：15 January 2025，
  
  Published：28 December 2025
- 稿件说明：
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张可,敬维维,李丹等.MPVR评估肺磨玻璃结节侵袭性的价值[J].重庆医科大学学报,2025,50(12):1656-1661.

Zhang Ke,Jing Weiwei,Li Dan,et al.Value of multi-planar volume reconstructions in evaluating the aggressiveness of lung ground glass nodules[J].Journal of Chongqing Medical University,2025,50(12):1656-1661.
张可,敬维维,李丹等.MPVR评估肺磨玻璃结节侵袭性的价值[J].重庆医科大学学报,2025,50(12):1656-1661. DOI： 10.13406/j.cnki.cyxb.003740.

Zhang Ke,Jing Weiwei,Li Dan,et al.Value of multi-planar volume reconstructions in evaluating the aggressiveness of lung ground glass nodules[J].Journal of Chongqing Medical University,2025,50(12):1656-1661. DOI： 10.13406/j.cnki.cyxb.003740.

摘要

目的

基于图像多平面容积重建（multi-planar volume reconstructions，MPVR），构建磨玻璃结节（ground glass nodule，GGN）浸润性腺癌（invasive adenocarcinoma，IAC）诊断模型并评估其诊断价值。

方法

回顾性分析2016年1月至2018年10月在重庆医科大学附属第一医院胸外科进行手术的GGN病例影像及临床资料，按照2∶1的比例随机分为训练组和验证组。在训练组中，以病理结果为金标准将病例分为不典型腺瘤样增生（antypical adenomatous hyperplasia，AAH）/原位腺癌（adenocarcinoma in situ，AIS）/微浸润性腺癌（microinvasive adenocarcinoma，MIA）和IAC组，比较2组临床及影像学特征，采用单因素-多因素logistic回归分析筛选预测浸润性腺癌的独立危险因素，并构建IAC诊断模型，采用受试者工作特征（receiver operating characteristic，ROC）曲线分析模型的诊断效能并使用组内相关系数（intraclass correlation coefficient，ICC）评估测量重复性。

结果

共425例GGN病例纳入研究，其中训练组280例，验证组145例。结节最大直径（

=0.016）、MPVR-实性成分最大直径（

=0.019）是预测IAC的独立危险因素。结节最大直径、MPVR-实性成分最大直径、MPVR-CTR和logistic回归模型预测浸润性腺癌的AUC在训练组中分别为0.895（95%CI=0.857~0.932）、0.977（95%CI=0.960~0.995）、0.960（95%CI=0.938~0.982）和0.985（95%CI=0.975~0.996），在验证组中分别为0.822（95%CI=0.754~0.890）、0.974（95%CI=0.952~0.997）、0.957（95%CI=0.928~0.985）和0.978（95%CI=0.958~0.997）。MPVR-实性成分最大直径测量的观察者间一致性很好（ICC=0.824），结节最大直径测量的观察者间一致性中等（ICC=0.687）。

结论

MPVR评估浸润性肺腺癌具有重要价值，与计算机体层成像（computed tomography，CT）征象结合可提高诊断效能。

Abstract

Objective

To construct a diagnostic model for invasive adenocarcinoma（IAC） manifesting as ground glass nodules （GGN） based on multi-planar volume reconstructions（MPVR），and to investigate its diagnostic value.

Methods

A retrospective analysis was performed for the imaging and clinical data of GGN cases who underwent surgery in Department of Thoracic Surgery，The First Affiliated Hospital of Chongqing Medical University，from January 2016 to October 2018，and they were randomly divided into training group and validation grou

p in a ratio of 2∶1. The cases in the training group were divided into atypical adenomatoid hyperplasia （AAH）/adenocarcinoma

in situ

（AIS）/minimally invasive adenocarcinoma（MIA） group and IAC group based on the gold standard of pathological results，and related clinical and imaging characteristics were compared between the two groups. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors for predicting IAC and construct a diagnostic model for IAC. The receiver operating characteristic（ROC） curve was used to evaluate the diagnostic efficacy of the model，and the intraclass correlation coefficient（ICC） was used to assess measurement repeatability.

Results

A total of 425 cases of GGN were included in the study，with 280 cases in the training group and 145 cases in the validation group. The maximum diameter of nodules（

=0.016） and the maximum diameter of MPVR solid components（

=0.019） were independent risk factors for predicting IAC. In the training group，the maximum diameter of nodules，the maximum diameter of MPVR solid components，MPVR-CTR，and the logistic regression model had an area under the ROC curve（AUC） of 0.895（95%CI=0.857-0.932），0.977（95%CI=0.960-0.995），0.960（95%CI=0.938-0.982），and 0.985（95%CI=0.975-0.996），respectively，in predicting IAC，while in the validation group，they had an AUC of 0.822 （95%CI=0.754-0.890），0.974（95%CI=0.952-0.997），0.957（95%CI=0.928-0.985），and 0.978（95%CI=0.958-0.997），respectively. The maximum diameter of MPVR solid components showed an excellent inter-observer consistency（ICC=0.824），while the maximum diameter of nodules showed a moderate inter-observer consistency（ICC=0.687）.

Conclusion

MPVR has an important value in evaluating invasive lung adenocarcinoma，and its combination with computed tomography features can improve diagnostic efficiency.

关键词

Keywords

references

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