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The relationships of the pulmonary arteries to lung lesions aid in differential diagnosis using computed tomography.

Lin CH, Li TC, Tsai PP, Lin WC - Biomedicine (Taipei) (2015)

Bottom Line: The average degrees of pulmonary arterial encasement in benign and malignant lesions were 52.1% ± 27.3% and 71.8% ± 18.8%, respectively (P = 0.011).The ROC curve showed that the degree of pulmonary arterial encasement had a moderate discriminating ability in diagnosing lung carcinoma, and the area under the curve was 0.738.The best cutoff value was 44.4%.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Children's Hospital, China Medical University Hospital, 404, Taichung, Taiwan.

ABSTRACT
The improvement of the resolution of rapid scanning in multidetector computed tomography (CT) has an increased accuracy that allows for the demonstration of the relationship of the pulmonary arteries and lung lesions, even in the peripheral lung. The purpose of this study is to evaluate the relationship between the pulmonary arteries and lung lesions by CT, and to use this relationship to distinguish between benign and malignant lung lesions. The relationships of the lung lesions and the adjacent pulmonary artery were recorded as encasement, displacement, penetration, in the margin, and disconnection. Statistical analyses were then performed to evaluate the relationship of the pulmonary arteries to each lesion with a focus toward the possibility of malignancy and the degree of pulmonary arterial encasement in the lesion. The relationship between the pulmonary arteries and lung lesions had a statistically significant difference between benignancy and malignancy (P < 0.001). Inter-observer agreement was substantial (κ = 0.639; 95% CI: 0.518-0.719). The average degrees of pulmonary arterial encasement in benign and malignant lesions were 52.1% ± 27.3% and 71.8% ± 18.8%, respectively (P = 0.011). The ROC curve showed that the degree of pulmonary arterial encasement had a moderate discriminating ability in diagnosing lung carcinoma, and the area under the curve was 0.738. The best cutoff value was 44.4%. The relationships of the pulmonary arteries to lung lesions and the degree of pulmonary arterial encasement could be used in differentiating benignancy from malignancy not only for central lung lesions but also peripheral lung lesions.

No MeSH data available.


Related in: MedlinePlus

The ROC curve for diagnosis of malignancy using the degree of pulmonary arterial encasement. Points labeled in the picture are the values of degree of encasement.
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Fig5: The ROC curve for diagnosis of malignancy using the degree of pulmonary arterial encasement. Points labeled in the picture are the values of degree of encasement.

Mentions: The lesions with different types of pulmonary arterial encasement that were related to the calculation of the degree of encasement are presented in Table 5. The average degrees of pulmonary arterial encasement in benign and malignant lesions were 52.1% ± 27.3% and 71.8% ± 18.8% (P = 0.011), respectively. The empirical ROC curve for the diagnosis of a malignant lung tumor with the degree of pulmonary arterial encasement showed a moderate discriminating ability in diagnosing lung carcinoma, and the area under the ROC curve was 0.738 (Figure 5). The best cutoff value for the degree of pulmonary arterial encasement in the diagnosis of malignancy was 44.4%. If 44.4% was chosen as the cutoff value for diagnosing malignancy of a lung tumor with said degree of pulmonary arterial encasement, then the sensitivity was 96.6% (56/58), specificity was 62.5% (5/8), positive predictive value was 94.9% (56/59), and negative predictive value was 71.4% (5/7), respectively. The 2 false negative results came from squamous cell carcinoma, and these 2 nodules both had 40% encasement. The 3 false positive results came from 3 tuberculosis (TB) lesions with 71%, 74% and 100% encasement, respectively.


The relationships of the pulmonary arteries to lung lesions aid in differential diagnosis using computed tomography.

Lin CH, Li TC, Tsai PP, Lin WC - Biomedicine (Taipei) (2015)

The ROC curve for diagnosis of malignancy using the degree of pulmonary arterial encasement. Points labeled in the picture are the values of degree of encasement.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4502046&req=5

Fig5: The ROC curve for diagnosis of malignancy using the degree of pulmonary arterial encasement. Points labeled in the picture are the values of degree of encasement.
Mentions: The lesions with different types of pulmonary arterial encasement that were related to the calculation of the degree of encasement are presented in Table 5. The average degrees of pulmonary arterial encasement in benign and malignant lesions were 52.1% ± 27.3% and 71.8% ± 18.8% (P = 0.011), respectively. The empirical ROC curve for the diagnosis of a malignant lung tumor with the degree of pulmonary arterial encasement showed a moderate discriminating ability in diagnosing lung carcinoma, and the area under the ROC curve was 0.738 (Figure 5). The best cutoff value for the degree of pulmonary arterial encasement in the diagnosis of malignancy was 44.4%. If 44.4% was chosen as the cutoff value for diagnosing malignancy of a lung tumor with said degree of pulmonary arterial encasement, then the sensitivity was 96.6% (56/58), specificity was 62.5% (5/8), positive predictive value was 94.9% (56/59), and negative predictive value was 71.4% (5/7), respectively. The 2 false negative results came from squamous cell carcinoma, and these 2 nodules both had 40% encasement. The 3 false positive results came from 3 tuberculosis (TB) lesions with 71%, 74% and 100% encasement, respectively.

Bottom Line: The average degrees of pulmonary arterial encasement in benign and malignant lesions were 52.1% ± 27.3% and 71.8% ± 18.8%, respectively (P = 0.011).The ROC curve showed that the degree of pulmonary arterial encasement had a moderate discriminating ability in diagnosing lung carcinoma, and the area under the curve was 0.738.The best cutoff value was 44.4%.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Children's Hospital, China Medical University Hospital, 404, Taichung, Taiwan.

ABSTRACT
The improvement of the resolution of rapid scanning in multidetector computed tomography (CT) has an increased accuracy that allows for the demonstration of the relationship of the pulmonary arteries and lung lesions, even in the peripheral lung. The purpose of this study is to evaluate the relationship between the pulmonary arteries and lung lesions by CT, and to use this relationship to distinguish between benign and malignant lung lesions. The relationships of the lung lesions and the adjacent pulmonary artery were recorded as encasement, displacement, penetration, in the margin, and disconnection. Statistical analyses were then performed to evaluate the relationship of the pulmonary arteries to each lesion with a focus toward the possibility of malignancy and the degree of pulmonary arterial encasement in the lesion. The relationship between the pulmonary arteries and lung lesions had a statistically significant difference between benignancy and malignancy (P < 0.001). Inter-observer agreement was substantial (κ = 0.639; 95% CI: 0.518-0.719). The average degrees of pulmonary arterial encasement in benign and malignant lesions were 52.1% ± 27.3% and 71.8% ± 18.8%, respectively (P = 0.011). The ROC curve showed that the degree of pulmonary arterial encasement had a moderate discriminating ability in diagnosing lung carcinoma, and the area under the curve was 0.738. The best cutoff value was 44.4%. The relationships of the pulmonary arteries to lung lesions and the degree of pulmonary arterial encasement could be used in differentiating benignancy from malignancy not only for central lung lesions but also peripheral lung lesions.

No MeSH data available.


Related in: MedlinePlus