Multicenter analysis of high-resolution computed tomography and positron emission tomography/computed tomography findings to choose therapeutic strategies.

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Multicenter analysis of high-resolution computed tomography and positron emission tomography/computed tomography findings to choose therapeutic strategies for clinical stage IA lung adenocarcinoma Morihito Okada, MD, PhD, Haruhiko Nakayama, MD, PhD, Sakae Okumura, MD, PhD, Hiromitsu Daisaki, PhD, Shuji Adachi, MD, PhD, Masahiro Yoshimura, MD, PhD, Yoshihiro Miyata, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 141, Issue 6, Pages 1384-1391 (June 2011) DOI: 10.1016/j.jtcvs.2011.02.007 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 maxSUV adjusted using experimental phantom (revised maxSUV). Original maxSUV data were calibrated by multiplying calibration factors based on phantom studies to correct inter-institutional SUV variability. MaxSUV ratio is expressed as maxSUV of each institute for maxSUV of control institute (Institute 1). maxSUV, Maximum standardized uptake value. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1384-1391DOI: (10.1016/j.jtcvs.2011.02.007) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 ROC curves for positive predictive values of pathologic lymph node metastasis, lymphatic invasion, blood vessel invasion, or pleural invasion. ROC curves are for revised maxSUV (A), GGO ratio (B), TDR (C), and BAC ratio (D). maxSUV, Maximum standardized uptake value; GGO, ground-glass opacity; TDR, tumor disappearance rate; BAC, bronchioloalveolar carcinoma; AUC, area under the curve; SUV, standardized uptake value. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1384-1391DOI: (10.1016/j.jtcvs.2011.02.007) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 DFS curves according to grade of revised maxSUV (A), GGO ratio (B), TDR (C), and BAC ratio (D). maxSUV, Maximum standardized uptake value; GGO, ground-glass opacity; TDR, tumor disappearance rate; BAC, bronchioloalveolar carcinoma. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1384-1391DOI: (10.1016/j.jtcvs.2011.02.007) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Overall survival curves according to grade of revised maxSUV (A), GGO ratio (B), TDR (C), and BAC ratio (D). maxSUV, Maximum standardized uptake value; GGO, ground-glass opacity; TDR, tumor disappearance rate; BAC, bronchioloalveolar carcinoma. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1384-1391DOI: (10.1016/j.jtcvs.2011.02.007) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Tumor (1.5 cm in diameter) located at right middle lobe. A, HRCT findings show GGO ratio of 5%. B, PET/CT findings show no accumulation. Microscope findings show BAC with mucin formation (C and D, staining with hematoxylin–eosin at ×25 and ×200 magnification, respectively). The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1384-1391DOI: (10.1016/j.jtcvs.2011.02.007) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Relationship between tumor size and revised maxSUV level in cT1N0M0 adenocarcinomas. A, All patients. B, Tumor size ≤ 20 mm and revised maxSUV ≤ 3.0. Nodal metastasis (triangles); recurrence (rhombi); lymphatic, vascular, or pleural invasion without nodal metastasis (squares). maxSUV, Maximum standardized uptake value; N, lymph node; Ly, lymphatic; V, blood vessel; P, pleural. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1384-1391DOI: (10.1016/j.jtcvs.2011.02.007) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions