Can Quantitative Volumetric Analysis Predict Tumor Recurrence in the Patients with Mucinous Adenocarcinoma of the Lung After Surgical Resection?

Rationale and Objectives: Mucinous adenocarcinoma (MAC)is a distinct histologic variant subtype of lung adenocarcinomas. However, detailed radiologic findings and prognostic factors are still poorly understood. Thus, this study aimed to investigate the prognostic value of quantitative volumetric analysis of the computed tomography images of patients with MAC after. surgical resection. Materials and Methods: Semiautomatic segmentation from computed tomography images of 60 patients with pathologically confirmed MAC was performed and retrospectively reviewed. The main cutoff value in Hounsfield Units (HU)to predict tumor recurrence was defined by receiver-operating curve analysis. Solid volume of mass (SVM)was defined as the volume of HU greater than this cutoff, and solid ratio (Sratio)was defined as SVM divided by total volume. Each parameter was compared to clinicopathologic characteristics and maximum standardized uptake value. Disease-free survival (DFS)was assessed and was compared among patients. Univariate and multivariate Cox regression was performed to predict DFS of MAC. Results: The cutoff value of HU as determined by ROC analysis was 20 HU. SVM and Sratio were positively correlated with the maximum standardized uptake and pathologic invasion size, respectively (p < 0.001). SVM and Sratio were significantly higher in the recurrence group than in the no-recurrence group (p < 0.001). Multivariate Cox proportional hazards regression analysis revealed that the SVM (Hazard Ratio 1.016; 95% Confidence Interval 1.000–1.032; p = 0.048)and Sratio (Hazard Ratio 29.136; 95% Confidence Interval 1.419–598.191; p = 0.029)were independent significant predictors of DFS. Conclusion: Quantitative volumetric parameters can predict the prognosis of patients with MAC after surgical resection.