ground-glass opacity (GGO)

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Original Article Metastatic rate of lymph nodes in clinical stage I non-small-cell lung cancer patients with mixed ground-glass opacity versus pure ground-glass opacity: a systematic review and meta-analysis

Original Article Metastatic rate of lymph nodes in clinical stage I non-small-cell lung cancer patients with mixed ground-glass opacity versus pure ground-glass opacity: a systematic review and meta-analysis

Lung cancer is the most commonly diagnosed cancer as well as the leading cause of cancer deaths in both men and women [1]. In recent years, there have been rapid developments in imaging modalities and the worldwide use of radiographic screening methods such as low- dose helical computed tomography (CT), high- resolution computed tomography and positron emission tomography/computed tomography for the screening of early lung cancer [2-5]. This has therefore helped ensure an increase in the detection rate of ground-glass opacity (GGO) in patients with early-stage lung cancer [6-8]. Pure ground-glass opacity (Pure-GGO) is defi-
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Three Dimensional Ground Glass Opacity Ratio in CT Images Can Predict Tumor Invasiveness of Stage IA Lung Cancer

Three Dimensional Ground Glass Opacity Ratio in CT Images Can Predict Tumor Invasiveness of Stage IA Lung Cancer

Materials and Methods: We retrospectively reviewed 99 patients with completely resected stage IA lung adenocarcinoma. The correlation between several parameters [one-dimensional ground glass opacity (1D GGO) ratio, two-dimensional (2D) GGO ra- tio, three-dimensional (3D) GGO ratio, 1D solid size, 2D solid size, and 3D solid size] and tumor invasiveness according to IASLC/ ATS/ERS classification was investigated using receiver operating characteristic (ROC) analysis. Adenocarcinoma in situ and mini- mally invasive adenocarcinoma were referred to as noninvasive adenocarcinoma.
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Boundary optimization of Ground Glass 
		Opacity in CT images of lung cancer

Boundary optimization of Ground Glass Opacity in CT images of lung cancer

screening method in high risk individuals. For the success of the screening program, the outcome of the classification of malignancy and benignity is important. Among the pulmonary nodules Ground Glass Opacity (GGO) can be restricted to partly solid and Non-Solid. They appear very frequently in CT lung images and possess greater liability of being malignant compared with the solid ones [2], Normally non-solid GGO nodules show fuzzy boundaries, having highly identical intensity with its background, and part solid GGO nodules showing highly uneven variations in intensity (intensity inhomogeneity) and boundary shapes.
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Detection of pulmonary ground-glass opacity based on deep learning computer artificial intelligence

Detection of pulmonary ground-glass opacity based on deep learning computer artificial intelligence

Pulmonary ground-glass opacity (GGO) is defined as a hazy opacity that does not obscure the underlying bronchial structures or pulmonary vessels on high-resolution computed tomography [1]. GGOs can be observed in benign conditions, such as focal interstitial fibrosis, inflammation, and hemorrhage; preinvasive lesions, such as atypi- cal adenomatous hyperplasia and adenocarcinoma in situ; and malignancies, such as minimally invasive adenocarcinoma and lepidic-predominant invasive adenocarcino- mas [2]. Lung adenocarcinoma is the most common histologic subtype of lung cancer and shows high heterogeneity at the histological and cellular levels [3]. Patients with
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Original Article High prevalence of ground-glass opacity in synchronous multiple primary lung cancer

Original Article High prevalence of ground-glass opacity in synchronous multiple primary lung cancer

Abstract: Objectives: The detection rate of synchronous multiple primary lung cancer (SMPLC) has risen signifi- cantly over the past decades. We herein investigated the clinicopathological, radiological and molecular features of patients with SMPLC. Methods: We retrospectively reviewed and analyzed 97 consecutive patients who were diagnosed with SMPLC at West China Hospital of Sichuan University between 2014 and 2017. The 97 patients were classified into three groups according to the radiological feature of the tumors: 24 patients (24.7%) in Group A (all tumors being solid lesions), 36 (37.1%) in Group B [solid and ground-glass opacity (GGO) tumors coexisting] and 37 (38.2%) in Group C (all tumors being GGO lesions). Results: Of the 97 patients, 73 (75.3%) harbored at least one GGO tumor and 60.3% (129/214) of their surgically resected tumors were GGO tumors. Subgroup analyses found more females (P=0.046), non-smokers (P=0.013) and patients with three tumors (P=0.005) in Group C than in Group A. Additionally, both the largest tumor dimension and the sum of tumor dimension in Group C were smaller than those in Group A (P<0.001 for both). Concordance between histological subtyping and clinical diagnostic cri- teria was observed in 93.0% (53/57) of patients, and that between genetic analysis and clinical diagnostic criteria was identified in 46.2% (6/13) of patients. Conclusions: GGO tumor was quite common in SMPLC and the clinical characteristics of GGO SMPLC were different from solid SMPLC. Histological subtyping, instead of genotyping, could be advocated as an additional reference to differentiate SMPLC from intrapulmonary metastases.
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Ground-glass opacity heralding invasive lung adenocarcinoma with prodromal dermatomyositis: a case report

Ground-glass opacity heralding invasive lung adenocarcinoma with prodromal dermatomyositis: a case report

ALT: Alanine transaminase; AST: Aspartate transaminase; CK: Creatine kinase; CT: Computed tomography; CTR: Consolidation-tumor ratio; DM: Dermatomyositis; EGFR: Epidermal growth factor receptor; FDG: 18F-fluorodeoxyglucose; GGO: Ground-glass opacity; IMPP: Immune myopathy with perimysial pathology; IVIG: Intravenous immunoglobulin; LDH: Lactate dehydrogenase; PET: Positron emission tomography; PM: Polymyositis; SIR: Standardized incidence ratio; SUV: Standardized uptake value

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Advances in intelligent diagnosis methods for pulmonary ground-glass opacity nodules

Advances in intelligent diagnosis methods for pulmonary ground-glass opacity nodules

GGNs: ground glass nodules; GGO: ground glass opacity; CT: computed tomography; SSN: subsolid nodule; mGGO: mixed ground glass opacity; pGGO: pure ground glass opacity; CAD: computer-aided detection; IPAs: invasive pulmonary adenocarcinomas; m-CT: mean computed tomography; DLCST: Danish Lung Cancer Screening Trial; SPNs: solitary pulmonary nodules; fGGO: the focal ground glass opacity; PET: positron emission tomography; VDT: volume doubling time; MDT: mass doubling time; DKI: diffuse kurtosis imaging; MK: mean peak; SVM: support vector machines; LU-RADS: Lung-Reporting and Data System; ACCP: American College of Chest Physicians; POM: probability of malignancy; IASLC: The International Association for the Study of Lung Cancer; ATS: American Thoracic Society; ERS: European Respiratory Society; MTANNs: massive-training artificial neural networks; CNNs: convolutional neural networks; MC-CNN: Multi-crop Convolutional Neural Network; ROC: receiver operating characteristics; AUC: area under the receiver operator character- istic curve; CBIR: content-based image retrieval; NCI: National Cancer Institute; LIDC: Lung Image Database Consortium; SDAE: stacked denoising auto-encoder.
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Predictive value of mutant p53 expression index obtained from nonenhanced computed tomography measurements for assessing invasiveness of ground-glass opacity nodules

Predictive value of mutant p53 expression index obtained from nonenhanced computed tomography measurements for assessing invasiveness of ground-glass opacity nodules

Abbreviations: aah, atypical adenomatous hyperplasia; ais, adenocarcinoma in situ; anOVa, analysis of variance; aVg, average cT attenuation; cT, computed tomography; EI, expression index; GGO, ground-glass opacity; HU, Hounsfield units; IAC, invasive adenocarcinoma; LLL, left lower lobe; LSD, least significant difference; lUl, left upper lobe; MaX, maximum cT attenuation; Mia, minimally invasive adenocarcinoma; na, not associated, means the pairwise comparisons were not necessary; Pia, preinvasive adenocarcinoma; rll, right lower lobe; rMl, right middle lobe; rUl, right upper lobe; sTD, standard deviation of cT attenuation; TVs, total volumes.
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Clinical, pathological, and radiological characteristics of solitary ground-glass opacity lung nodules on high-resolution computed tomography

Clinical, pathological, and radiological characteristics of solitary ground-glass opacity lung nodules on high-resolution computed tomography

Results: Eighty-one adenocarcinoma and 14 benign nodules were observed. The nodules included 12 (15%) adenocarcinoma in situ (AIS), 14 (17%) minimally invasive adenocarci- noma (MIA), and 55 (68%) invasive adenocarcinoma (IA). No patients with recurrence till date have been identified. The positive expression rates of anaplastic lymphoma kinase and ROS-1 (proto-oncogene tyrosine-protein kinase ROS) were only 2.5% and 8.6%, respectively. The specificity and accuracy of HRCT of invasive lung adenocarcinoma were 85.2% and 87.4%. The standard uptake values of only two patients determined by 18F-FDG positron emission tomography/computed tomography (PET/CT) were above 2.5. The size, density, shape, and pleural tag of nodules were significant factors that differentiated IA from AIS and MIA. Moreover, the size, shape, margin, pleural tag, vascular cluster, bubble-like sign, and air bronchogram of nodules were significant determinants for mixed ground-glass opacity nodules (all P0.05).
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Identification of preoperative prediction factors of tumor subtypes for patients with solitary ground-glass opacity pulmonary nodules

Identification of preoperative prediction factors of tumor subtypes for patients with solitary ground-glass opacity pulmonary nodules

Results: Three hundred and ninety-three adenocarcinomas (92.9%) and 30 benign nodules were diagnosed. Age, the history of family cancer, serum carcinoembryonic antigen level, tumor size, ground-glass opacity types, and bubble-like sign in chest CT differed significantly between adenocarcinoma in situ / minimally invasive adenocarcinoma and invasive adenocarcinoma ( p :0.008, 0.046, 0.000, 0.000, 0.000 and 0.001). Receiver operating characteristic curves and univariate analysis revealed that patients with more than 58.5 years, a serum carcinoembryonic antigen level > 1.970 μ g/L, a tumor size> 13.50 mm, mixed ground-glass opacity nodules and a bubble-like sign were more likely to be diagnosed as invasive adenocarcinoma. The combination of five factors above had an area under the curve of 0.91, with a sensitivity of 82% and a specificity of 87%.
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Limited resection and two-staged lobectomy for non-small cell lung cancer with ground-glass opacity

Limited resection and two-staged lobectomy for non-small cell lung cancer with ground-glass opacity

Methods: Forty-one patients with undiagnosed small peripheral ground-glass opacity lesions underwent partial resection from 2001 to 2007 in Hokkaido University Hospital. Localized bronchioloalveolar carcinoma was classified according to the Noguchi classification for adenocarcinoma. Malignant lesions other than Noguchi types A and B were considered for completion lobectomy and systemic mediastinal lymphadenectomy. Perioperative data of completion video-assisted thoracoscopic lobectomies were compared with data of 67 upfront video-assisted thoracoscopic lobectomies for clinical stage IA adenocarcinoma performed during the same period.
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Original Article Preoperative prediction of Ki67 proliferation index obtained from non-enhanced CT measurements allows for assessing invasiveness and forecasting growth of ground-glass-opacity nodes

Original Article Preoperative prediction of Ki67 proliferation index obtained from non-enhanced CT measurements allows for assessing invasiveness and forecasting growth of ground-glass-opacity nodes

Doubling time (month) NA 27.45 ± 15.50 Note: PIA, preinvasive adenocarcinoma, including atypical adenomatous hyperpla- sia (AAH) and adenocarcinoma in situ (AIS); IA, invasive adenocarcinoma, including minimally invasive adenocarcinoma; LUL, left upper lobe; LLL, left lower lobe; RUL, right upper lobe; RML, right median lobe; RLL, right lower lobe; TV, total volume; MAX, AVG and STD denotes maximal, average and standard deviation of CT attenuation within ground-glass-opacity nodes; HU, Hounsfield unit; PI, proliferation index. Unless otherwise indicated, numerical variables were recorded as mean ± standard deviation. P1 indicates difference significance of variables between PIA and IA, while P2 indicates difference significance among levels of categorical variables. *, Chi square test; §, Student t test. NA, not associated.
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Gender Does Not Have a Potential Predictive Value for the Presence of Epidermal Growth Factor Receptor Mutation in Lung Adenocarcinoma

Gender Does Not Have a Potential Predictive Value for the Presence of Epidermal Growth Factor Receptor Mutation in Lung Adenocarcinoma

Background: Previous studies reported that non-small cell carcinoma patients characterized by female gender, never-smoking status and adenocarcinoma histology were more likely to harbor epidermal growth factor receptor (EGFR) mutations. However, some studies failed to find the rela- tionship between EGFR mutation and gender. Methods: One hundred and eighty-four consecutive patients (90 men and 94 women) of resected lung adenocarcinoma were studied retrospectively. Since the smoking rate is significantly higher in men, we assumed that gender difference might be a seeming factor affected by smoking. Therefore we subdivided the patients into 2 groups: never- and ever-smokers. Results: The number of ever-smokers was 94.44% in men, whereas 8.51% in women. EGFR mutation was positive in 48.9%. For overall patients, EGFR mutation status was as- sociated with gender, pStage, pT status, lepidic dominant histologic subtype, pure/mixed ground- glass opacity (GGO) on computed tomography (CT) and smoking status. However, in ever-smokers, EGFR mutation status was associated with lepidic histologic subtype and GGO on CT, but not others including gender. Similar results were also found in never-smokers, and gender was not also re- lated to EGFR mutation in never smokers. Conclusion: The EGFR mutational frequency among men and women was not significantly different when lung adenocarcinoma patients were stratified into never- and ever-smokers.
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Surgical treatment to multiple primary lung cancer patients: a systematic review and meta-analysis

Surgical treatment to multiple primary lung cancer patients: a systematic review and meta-analysis

ACCP: American College of Chest Physicians; ADK: Adenocarcinoma; AIS: Adenocarcinoma In Situ; BTS: British Thoracic Society; CI: Confidence Interval; CSCO: Chinese Society of Clinical Oncology; GGO: Ground Glass Opacity; HR: Hazard Ratio; MET: Metachronous; MPLC: Multiple Primary Lung Cancer; NCCN: National Comprehensive Cancer Network; NOS: the Newcastle-Ottawa Scale; NSCLC: Non-Small Cell Lung Cancer; OS: Overall Survival; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta- Analyses; SCC: Squamous Cell Carcinoma; SE: Standard Error;

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Clinico- pathologic presentation of hypersensitivity pneumonitis in Egyptian patients: a multidisciplinary study

Clinico- pathologic presentation of hypersensitivity pneumonitis in Egyptian patients: a multidisciplinary study

BAL: Bronchioloalveolar lavage; CPAP: Continuous positive airway pressure; DPLD: Diffuse parenchymal lung diseases; GGO: Ground glass opacity; HP: Hypersensitivity pneumonitis; HRCT: High resolution computed tomography; IgE: Immunoglobulin E; IMNGCs: Isolated multinucleated giant cells; IPF: Idiopathic pulmonary fibrosis; LIP: Lymphocytic interstitial pneumonia; MDD: Multidisciplinary discussion; NSIP: Non specific interstitial pneumonia; OP: Organizing pneumonia; PAP: Pulmonary alveolar proteinosis; TBLB: Transbronchial lung biopsy; UIP: Usual interstitial pneumonia; VATS: Video-assisted thoracoscopic surgery
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Small lung lesions invisible under fluoroscopy are located accurately by three-dimensional localization technique on chest wall surface and performed bronchoscopy procedures to increase diagnostic yields

Small lung lesions invisible under fluoroscopy are located accurately by three-dimensional localization technique on chest wall surface and performed bronchoscopy procedures to increase diagnostic yields

Nowadays, with the application of high-resolution com- puted tomography (CT) imaging techniques to lung can- cer screening, small solitary pulmonary nodule (SPN) or ground-glass opacity (GGO) lesions in the lung are fre- quently detected [1, 2]. For this article, the small periph- eral pulmonary lesions (PPLs) are defined as lesions less than 3 cm in length, including the SPN, GGO or mixed GGO (mGGO) and being surrounded by the lung paren- chyma without evidence of endobronchial abnormalities. The differential diagnosis of PPN is broad, ranging from benign tumors, edema, infectious lesions to lung cancer and other malignant conditions [3]. Lung cancer is the most common cause of cancer death for both men and women with a 5-year global survival rate in patients in the early stages of the disease of 38 – 67% and in later stages of 1 – 8% [4]. Thus, the prognosis of lung cancer depends on the early diagnosis of these lesions. When biopsy is recommended, CT-guided transthoracic fine- needle aspiration (TTNA) or biopsy is currently pre- ferred because it has a diagnostic yield of 90%, although perhaps less with smaller lesions [5]. However, TTNA has limitations such as without bronchoalveolar lavage fluid (BALF), brushing, and with respect to the puncture site, seeding along the needle biopsy tract with malig- nant cells which are potentially serious, with a risk from 0.06 to 1%, as well as a high risk of complications such as a pneumothorax median 25% (range 4 – 60%), among which 4% (range 0.2 – 8%) for pneumothorax requiring chest tube and the median risk of hemorrhage is 12% (range 2 – 66%), and may be higher in the diffuse lung disease patients with bulla under pleura and those with smaller nodules or nodules deep in the lung parenchyma [6, 7]. Another more complex process video-assisted thoracoscopic surgery (VATS), even CT assisted VATS [8] is also an alternative method to obtain the tissue samples especially for some small PPNs. However, some- times the techniques need an additional tool such as O- arm CT or some preoperative marking procedures to identify the location of the small lesions [9, 10]. For ex- ample, VATS involves hook-wire technique, endoscopic
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<p>Spread Through Air Spaces (STAS) in Lung Cancer: A Multiple-Perspective and Update Review</p>

<p>Spread Through Air Spaces (STAS) in Lung Cancer: A Multiple-Perspective and Update Review</p>

3D, three-dimensional; ADC, adenocarcinoma; CIR, cumulative incidence of recurrence; CT, computed tomo- graphy; DFS, disease-free survival; GGO, ground-glass opacity; IMA, invasive mucin[r]

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Radial endobronchial ultrasound with a guide sheath for diagnosis of peripheral cavitary lung lesions: a retrospective study

Radial endobronchial ultrasound with a guide sheath for diagnosis of peripheral cavitary lung lesions: a retrospective study

Patient information (age, sex, type of procedure) and lesion characteristics were collected prospectively in the database before diagnostic bronchoscopy. Lesion characteristics, in- cluding type (solid, part-solid, pure ground-glass opacity [GGO], cavitary, or other [i.e., atelectasis, diffuse or lobar consolidation]), maximum diameter, target bronchus, and presence of bronchus sign, were evaluated on thin-section chest CT images during regular team discussions that in- cluded board-certified bronchoscopists, pulmonologists, and medical oncologists. VBN (LungPoint, Bronchus Ltd.) was used when the target bronchus was small and difficult to trace [11].
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Pulmonary strongyloidiasis: assessment between manifestation and radiological findings in 16 severe strongyloidiasis cases

Pulmonary strongyloidiasis: assessment between manifestation and radiological findings in 16 severe strongyloidiasis cases

Results: Sixteen severe strongyloidiasis cases were included. Of those, fifteen cases had pulmonary manifestations, eight had acute respiratory distress syndrome (ARDS) (53%), seven had enteric bacterial pneumonia (46%) and five had pulmonary hemorrhage (33%). Acute respiratory failure was a common indicator for pulmonary manifestation (87%). Chest X-ray findings frequently showed diffuse shadows (71%). Additionally, ileum gas was detected for ten of the sixteen cases in the upper abdomen during assessment with chest X-ray. While, chest CT findings frequently showed ground-glass opacity (GGO) in 89% of patients. Interlobular septal thickening was also frequently shown (67%), always accompanying GGO in upper lobes.
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Postoperative recurrence of clinical early-stage non-small cell lung cancers: a comparison between solid and subsolid nodules

Postoperative recurrence of clinical early-stage non-small cell lung cancers: a comparison between solid and subsolid nodules

NSCLCs are classified clinically into solid nodules, including only solid components, and subsolid nod- ules, including ground-glass opacity (GGO) compo- nents, based on thin-section CT findings. Some previous studies have focused on the solid compo- nent that reflects the intra-tumoral collapse of the airspace or fibrosis within the subsolid nodules and have demonstrated that the solid size (SS), which is the maximal diameter of the solid component, correlates with tumor invasiveness and patient prognosis [4 – 7]. Therefore, SS measurements have been adopted as the

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