Computer-aided diagnosis of lung cancer: definition and detection of ground-glass opacity type of nodules by high-resolution computed tomography

Purpose The ground-glass opacity (GGO) of lung cancer is identified only subjectively on computed tomography (CT) images as no quantitative characteristic has been defined for GGOs. We sought to define GGOs quantitatively and to differentiate between GGOs and solid-type lung cancers semiautomatically with a computer-aided diagnosis (CAD). Methods and materials High-resolution CT images of 100 pulmonary nodules (all peripheral lung cancers) were collected from our clinical records. Two radiologists traced the contours of nodules and distinguished GGOs from solid areas. The CT attenuation value of each area was measured. Differentiation between cancer types was assessed by a receiver-operating characteristic (ROC) analysis. Results The mean CT attenuation of the GGO areas was −618.4 ± 212.2 HU, whereas that of solid areas was −68.1 ± 230.3 HU. CAD differentiated between solidand GGO-type lung cancers with a sensitivity of 86.0% and specificity of 96.5% when the threshold value was −370 HU. Four nodules of mixed GGOs were incorrectly classified as the solid type. CAD detected 96.3% of GGO areas when the threshold between GGO and solid areas was 194 HU. Conclusion Objective definition of GGO area by CT attenuation is feasible. This method is useful for semiautomatic differentiation between GGOs and solid types of lung cancer.