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1
Department of Radiology, Shinshu University School of Medicine, Asahi 3-1-1,
Matsumoto, 390 8621, Japan.
2
Present address: Azumi General Hospital, Ikeda, Nagano, 399-8695, Japan.
3
Department of Laboratory Medicine, Shinshu University School of Medicine,
Asahi, Matsumoto, 390 8621, Japan.
OBJECTIVE. The purpose of this study was to determine the correlation between high-resolution CT morphologic features of small peripheral lung adenocarcinomas and tumor growth patterns.
MATERIALS AND METHODS. We examined high-resolution CT morphologic features of 59 small, surgically resected peripheral lung adenocarcinomas (diameter, 6-20 mm) that were detected on screening for lung cancer using low-dose helical CT. Among these adenocarcinomas, 14 (24%) were visible and 45 (76%) were invisible on conventional chest radiography. The correlation between high-resolution CT morphologic features and tumor growth patterns was analyzed.
RESULTS. Sixteen (94%) of 17 type A (Noguchi's classification) adenocarcinomas appeared as nodules of pure ground-glass attenuation (high-resolution CT type I). Ten (71%) of 14 type B tumors appeared as heterogeneous, low-attenuation nodules (type II). Seven (29%) of 24 type C tumors appeared as nodules with ground-glass attenuation in the periphery and a high-density central zone (type III), and 12 (50%) of 24 type C tumors appeared as homogeneous nodules with soft-tissue density (type IV). Among tumors with a replacement growth pattern, the size and CT values of type C tumors were larger than those of type A or type B tumors (p < 0.05), whereas the percentage of ground-glass attenuation and retained air space in type C tumors was smaller than those in type A or type B tumors (p < 0.01). All (100%) four type D tumors appeared to be homogeneous nodules with soft-tissue density (type IV).
CONCLUSION. Small peripheral lung adenocarcinomas shown on CT exhibit four high-resolution CT patterns that corresponded to the histopathologic findings of different tumor growth patterns.
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