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  P1.11 - Screening and Early Detection (Not CME Accredited Session) (ID 943)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall

  • 26548

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    P1.11-04 - Size Measurement Variability of Solid Component of Lung Adenocarcinoma (ID 12451)

    16:45 - 18:00  |  Presenting Author(s): Kazutoshi Hamanaka
    • Abstract
    • Slides

    Background
    

    In the current TNM classification for lung cancer, the solid size is used for tumor diameter measurement as dense component. However, in daily practice, it is sometimes difficult to measure the solid size, so the variability between the observer may increase, and therefore it is presumed that the measurement variability between radiological and pathological size become large particularly in subsolid nodules. In this study, we investigate the interobserver variability and differences between the radiological and pathological tumor size in lung adenocarcinoma.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Interobserver variability: We assessed 47 cases of subsolid type lung adenocarcinoma operated in our department from January to December 2016. Six physicians including surgeons and radiologist measured the solid and total size using preoperative CT and assessed the interobserver measurement variability. Furthermore, we assessed the interobserver variability using 5 subclassified patterns of the tumor.

    Radiological-pathological variability: Radiological-pathological variability in measurement of solid size in adenocarcinoma using database of 554 surgical cases from January 2010 to Jun 2017 was investigated. We also assessed the stage migration using radiological and pathological T stage classified by only tumor size.

    4c3880bb027f159e801041b1021e88e8 Result
    

    The mean interobserver variability of six observers of 47 cases was 9.7 mm in solid size, and 7.7 mm in total size. The tumor images were subclassified into the following 5 patterns: ①minimally invasive ②peribronchovascular ③spicula/atelectasis ④adjacent to cystic lesions ⑤pneumonia-like consolidation. To correct for differences in mean tumor diameter in each pattern, comparison was made using coefficient of variation (CV) calculated by SD/mean. The pattern of minimally invasive (①) became the largest value for CV in the measurement of solid size.

    The mean radiological-pathological variability of 554 cases was 5.9 mm in solid size, and 5.4 mm in total size. In cases of Tis, T1mi in T stage, and adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA) in histological type, the CVs were larger than others. The comparison of radiological and pathological T stage, the accurate staging rate was 41.8%, and upstage were seen in 28.8% in all cases.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Interobserver measurement variability of solid size of the lung adenocarcinoma was larger than those of total size. The difference between radiological and pathological invasion size tend to be larger in small-sized tumor as Tis and T1mi, and low-grade malignant potential lesions as AIS and MIA．Therefore, a careful consideration must be given to decide the management plan of these cases.

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