A simple prediction model using size measures for discrimination of invasive adenocarcinomas among incidental pulmonary subsolid nodules considered for resection.
Objectives: To develop and validate a concise prediction model using simple size measures for the discrimination of invasive pulmonary adenocarcinomas (IPAs) among incidentally detected subsolid nodules (SSNs) considered for resection and to compare its diagnostic performance with the Brock model.Me...
| Publicado en: | European Radiology Vol. 29; no. 4; pp. 1674 - 1684 |
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| Autores principales: | , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Springer Nature
Apr2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=135371936&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 135371936 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Apr2019 vid: 29 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 135371936 135371936 NLM30255253 135371936 10.1007/s00330-018-5739-x NLM30255253 135371936 ppf: 1674 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: A simple prediction model using size measures for discrimination of invasive adenocarcinomas among incidental pulmonary subsolid nodules considered for resection. aug: au: Kim, Hyungjin Goo, Jin Mo Park, Chang Min affil: Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehak-ro, Jongno-gu, 03080, Seoul, Korea sug: subj: Lung Neoplasms Pathology Logistic Regression Adenocarcinoma in Situ Surgery Male Aged Retrospective Design Neoplasm Invasiveness Predictive Value of Tests Tomography, X-Ray Computed Methods Adenocarcinoma in Situ Lung Neoplasms Lung Neoplasms Surgery Diagnosis, Differential ROC Curve Female Sensitivity and Specificity Adenocarcinoma in Situ Pathology Middle Age Human Aged: 65+ years Middle Aged: 45-64 years Male Female ab: Objectives: To develop and validate a concise prediction model using simple size measures for the discrimination of invasive pulmonary adenocarcinomas (IPAs) among incidentally detected subsolid nodules (SSNs) considered for resection and to compare its diagnostic performance with the Brock model.Methods: This retrospective institutional review board-approved study included 427 surgically resected SSNs (121 preinvasive lesions/minimally invasive adenocarcinomas [MIAs] and 306 IPAs) from 407 patients. After stratified random splitting of the study population into the training and validation sets (3:1), a simple logistic model was constructed using nodule size, solid proportion, and type for the differentiation of IPAs. Diagnostic performance of this model was compared with the original and modified Brock models using the DeLong method for area under the receiver-operating characteristic curve (AUC) and McNemar test for diagnostic sensitivity and specificity.Results: Our proposed model had an AUC of 0.859 in the validation set, while the original Brock model showed an AUC of 0.775 (p = 0.035) and the modified Brock model exhibited an AUC of 0.787 (p = 0.006). At equally high specificity of 90%, our proposed model exhibited significantly higher sensitivity (65.8%) than the original and modified Brock models (38.2% and 50.0%; p < 0.001 and 0.008, respectively).Conclusions: Our study results demonstrated that the proposed concise model outperformed both Brock models, demonstrating its potential to be utilized as a specific tool to differentiate IPAs from preinvasive lesions and MIAs, which were considered for resection. External validation studies are warranted for the population with incidentally detected SSNs including small SSNs to confirm our observations.Key Points: • Size measures provided sufficient information for the risk stratification of surgical candidate incidental subsolid nodules. • Our proposed concise model showed higher diagnostic performance than the Brock model for incidentally detected subsolid nodules. • Our proposed model can specifically differentiate invasive adenocarcinomas among incidentally detected subsolid nodules and reduce overtreatment for indolent subsolid nodules. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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