Software performance in segmenting ground-glass and solid components of subsolid nodules in pulmonary adenocarcinomas

J. Cohen, J. Goo, R. Yoo, C. Park, C. Lee, B. van Ginneken, D. Chung and Y. Kim

European Radiology 2016;26(12):4465-4474.

DOI PMID Cited by ~31

To evaluate the performance of software in segmenting ground-glass and solid components of subsolid nodules in pulmonary adenocarcinomas.Seventy-three pulmonary adenocarcinomas manifesting as subsolid nodules were included. Two radiologists measured the maximal axial diameter of the ground-glass components on lung windows and that of the solid components on lung and mediastinal windows. Nodules were segmented using software by applying five (-850A-A?A 1/2 HU to -650A-A?A 1/2 HU) and nine (-130A-A?A 1/2 HU to -500A-A?A 1/2 HU) attenuation thresholds. We compared the manual and software measurements of ground-glass and solid components with pathology measurements of tumour and invasive components.Segmentation of ground-glass components at a threshold of -750A-A?A 1/2 HU yielded mean differences of +0.06A-A?A 1/2 mm (p=0.83, 95% limits of agreement, 4.51 to 4.67) and -2.32A-A?A 1/2 mm (p<0.001, -8.27 to 3.63) when compared with pathology and manual measurements, respectively. For solid components, mean differences between the software (at -350A-A?A 1/2 HU) and pathology measurements and between the manual (lung and mediastinal windows) and pathology measurements were -0.12A-A?A 1/2 mm (p=0.74, -5.73 to 5.55]), 0.15A-A?A 1/2 mm (p=0.73, -6.92 to 7.22), and -1.14A-A?A 1/2 mm (p<0.001, -7.93 to 5.64), respectively.Software segmentation of ground-glass and solid components in subsolid nodules showed no significant difference with pathology. - Software can effectively segment ground-glass and solid components in subsolid nodules. - Software measurements show no significant difference with pathology measurements. - Manual measurements are more accurate on lung windows than on mediastinal windows.