CT-maximal Diameters and mean CT value of Synchronous Multiple Lung Tumors Adenocarcinoma Are Smaller Than Solitary Lung Tumors In Pure Ground-glass Opacities

Background: The features of multiple GGOs, especially for synchronous multiple pure GGOs (SMpGGOs), remains unknown. This retrospective study aimed to investigate the clinical and radiological features of SMpGGOs. Methods: : Patients with solitary pure GGOs (SpGGOs) or SMpGGOs at Ningbo First Hospital from August 2018 to June 2020 were included. The clinical records and radiological image features between SpGGOs and SMpGGOs were compared. Data were analyzed using SPSS 21.0. Results: : 138 patients (58 patients with 58 SpGGOs, 80 patients with 187 SMpGGOs) were evaluated. According to the multivariate analyses, maximal diameter (p＜0.001) and mean CT value (p=0.003) were independent risk factors. Receiver operating curves revealed that the optimal threshold of maximal diameters was 12.5 mm for SpGGOs (sensitivity 54.5%, specificity 100%, AUC 0.851) and 5.5 mm for SMpGGOs (sensitivity 86.4%, specificity 55.6%, AUC 0.777). The optimal threshold of mean CT value was -531.9 Hu for SpGGOs (sensitivity 43.2%, specificity 100%, AUC 0.724) and -615.0 Hu for SMpGGOs (sensitivity 61.4%, specificity 66.7%, AUC 0.651). Conclusion: The maximal diameters and mean CT value were significant independent predictors for adenocarcinoma of pGGOs. In SMpGGOs, the optimal threshold of maximal diameters and mean CT value of adenocarcinoma were smaller than those of SpGGOs.