Nomogram for Predicting the Risk of Invasive Pulmonary Adenocarcinoma for Pure Ground-Glass Nodules Lijie Wang, MD, Weiyu Shen, MD, Yong Xi, MD, Shuai.

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Presentation transcript:

Nomogram for Predicting the Risk of Invasive Pulmonary Adenocarcinoma for Pure Ground-Glass Nodules Lijie Wang, MD, Weiyu Shen, MD, Yong Xi, MD, Shuai Liu, MD, Dawei Zheng, MD, Chenghua Jin, MD The Annals of Thoracic Surgery Volume 105, Issue 4, Pages 1058-1064 (April 2018) DOI: 10.1016/j.athoracsur.2017.11.012 Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

The Annals of Thoracic Surgery 2018 105, 1058-1064DOI: (10. 1016/j The Annals of Thoracic Surgery 2018 105, 1058-1064DOI: (10.1016/j.athoracsur.2017.11.012) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Computed tomography image shows air bronchogram (white arrow) in right upper lobe of 54-year-old woman with a pathology diagnosis of AIS. (B) Computed tomography image shows lobulation (white arrow) in right upper lobe of 42-year-old woman with pathology diagnosis of MIA. (C) Computed tomography image shows vascular convergence (white arrow) and pleural tag (blue arrow) in right middle lobe of 58-year-old woman with pathology diagnosis of invasive adenocarcinoma. The Annals of Thoracic Surgery 2018 105, 1058-1064DOI: (10.1016/j.athoracsur.2017.11.012) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) A 74-year-old man with a pathology diagnosis of adenocarcinoma in situ. The computed tomography image shows a 0.9 cm pure ground-glass nodule (arrows) in the left upper lobe. From left to right, followed by lung window, window width of 2,000 HU, 1,800 HU, 1,600 HU, and 1,400 HU. The size of the lesion decreased gradually and was invisible at a window width of 1,400 HU. (B) A 39-year-old woman with a pathology diagnosis of minimally invasive adenocarcinoma. The computed tomography image shows a 0.7 cm pure ground-glass nodule in the right upper lobe (arrows). From left to right, followed by lung window, window width of 2,000 HU, 1,600 HU, 1,200 HU, and 800 HU. The size of the lesion decreased gradually and was invisible at a window width of 800 HU. The Annals of Thoracic Surgery 2018 105, 1058-1064DOI: (10.1016/j.athoracsur.2017.11.012) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 A nomogram for predicting the probability of invasive pulmonary adenocarcinoma for patients with pure ground-glass nodules of 1 cm or less in diameter. The value of each variable was given a score on the point scale axis from 0 to 100. A total score could be easily calculated by adding each single score, and by projecting the total score to the lower total point scale, we were able to determine the corresponding predicted probability of invasive pulmonary adenocarcinoma (IPA). (CT = computed tomography.) The Annals of Thoracic Surgery 2018 105, 1058-1064DOI: (10.1016/j.athoracsur.2017.11.012) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 A nomogram calibration plot internal validation. The dots close to the top illustrate the distribution of predicted probabilities for invasive pulmonary adenocarcinoma. Perfect prediction would fall along the 45-degree line (dashed black line). The red dotted line represents the entire cohort (n = 250) and the blue solid line is bias corrected by bootstrapping (1,000 repetitions), indicating observed nomogram performance. The Annals of Thoracic Surgery 2018 105, 1058-1064DOI: (10.1016/j.athoracsur.2017.11.012) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 A nomogram calibration plot for external validation using another set of 181 patients (included benign lesions, n = 9; atypical adenomatous hyperplasia, n = 3; adenocarcinoma in situ, n = 57; minimally invasive adenocarcinoma, n = 96; and invasive adenocarcinoma, n = 16) with similar inclusion criteria operated on in another center from January 2016 to July 2017. Perfect prediction falls along the 45-degree line (dashed black line); red dotted line represents the entire cohort (n = 181) and blue solid line is bias-corrected. The Annals of Thoracic Surgery 2018 105, 1058-1064DOI: (10.1016/j.athoracsur.2017.11.012) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions