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Right arrow Lung - cancer

Ann Thorac Surg 2003;76:867-871
© 2003 The Society of Thoracic Surgeons


Original article: general thoracic

Differentiating between atypical adenomatous hyperplasia and bronchioloalveolar carcinoma using the computed tomography number histogram

Hiroaki Nomori, MD, PhDa*, Takashi Ohtsuka, MDa, Tsuguo Naruke, MD, PhDa, Keiichi Suemasu, MD, PhDa

a Department of Thoracic Surgery, Saiseikai Central Hospital, Tokyo, Japan

Accepted for publication April 17, 2003.

* Address reprint requests to Dr Nomori, Department of Thoracic Surgery, Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo 108-0073, Japan
e-mail: hnomori{at}qk9.so-net.ne.jp

BACKGROUND: Both atypical adenomatous hyperplasia (AAH) and bronchioloalveolar carcinoma (BAC) appear as ground glass opacity (GGO) lesions by computed tomography (CT) and are sometimes difficult to differentiate. To aid distinction between the two, we examined their CT number histograms.

METHODS: Histograms of pixel CT numbers were made for AAH (n = 9) and nonmucinous BAC (n = 8), and the peak and mean CT numbers on the histogram were quantified.

RESULTS: Although there was no significant difference in lesion size between AAH and BAC, all AAHs were less than or equal to 1 cm in diameter. All AAHs and BACs manifested one histogram peak. Both the peak and mean CT numbers on the histogram were significantly lower for AAH than for BAC (p < 0.001). However, the degree of overlap between AAH and BAC was less for the peak CT number than for the mean CT number.

CONCLUSIONS: The peak CT number on the histogram can help the radiologic differentiation between AAH and BAC. GGO lesions less than or equal to 1 cm in diameter that are diagnosed as AAH from the CT number histogram can be safely followed by CT.




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