{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T13:33:06Z","timestamp":1664371986580},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T00:00:00Z","timestamp":1608249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Clinical Research Foundation of Shanghai Pulmonary Hospital","award":["FK1936","FK1941","FK1942","FK1943"],"award-info":[{"award-number":["FK1936","FK1941","FK1942","FK1943"]}]},{"name":"Shanghai Municipal Health Commission","award":["2018ZHYL0102","2019SY072","201940018"],"award-info":[{"award-number":["2018ZHYL0102","2019SY072","201940018"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2002<\/jats:title>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>To investigate the impact of lung window (LW) and mediastinal window (MW) settings on the clinical T classifications and prognostic prediction of patients with subsolid nodules.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Seven hundred and nineteen surgically resected subsolid nodules were reviewed, grouping into pure ground-glass nodules (n\u2009=\u2009179) or part-solid nodules (n\u2009=\u2009540) using LW. Interobserver agreement on nodule classifications was assessed via kappa-value, and predictive performance of the solid portion measurement in LW and MW for pathological invasiveness and malignancy were compared using receiver-operating characteristic analysis. Cox regression was used to identify prognostic factors. Prognostic significance of T classifications based on LW (c[l]T) and MW (c[m]T) was evaluated by Kaplan\u2013Meier method after propensity score matching. The performance of c(m)T for discrimination survival was estimated via the concordance index (C-index), net reclassification improvement and integrated-discrimination improvement.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>By adopting MW, 124 part-solid nodules were reclassified as pure ground-glass nodules, and interobserver agreement improved to 0.917 (95% confidence interval 0.888\u20130.946). The solid portion size under MW more strongly predicted pathological invasiveness (P\u2009=\u20090.030), but did not better predict pathological malignancy. For remaining 416 part-solid nodules, c(l)T and c(m)T were both independent risk factors. c(m)T led to T classifications shifts in 321 nodules (14 upstaged and 307 downstaged) with no significant prognostic difference existing between the shifted c(m)T and matching c(l)T group after propensity score matching. The corrected C-index was improved to 0.695 (0.620\u20131.000) when adopting c(m)T with no significant difference in net reclassification improvement (P\u2009=\u20090.098) and integrated-discrimination improvement (P\u2009=\u20090.13) analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>As there is no significant benefit provided by MW in evaluating clinical T classification and prognosis, the current usage of LW is appropriate for assessing subsolid nodules.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa457","type":"journal-article","created":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T20:25:12Z","timestamp":1606767912000},"page":"1295-1303","source":"Crossref","is-referenced-by-count":1,"title":["Impact of computed tomography window settings on clinical T classifications and prognostic evaluation of patients with subsolid nodules"],"prefix":"10.1093","volume":"59","author":[{"given":"Mengmeng","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiajun","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingting","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingze","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junqi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifang","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiwen","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gening","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunlang","family":"She","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuming","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,12,18]]},"reference":[{"key":"2021061419592196300_ezaa457-B1","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1148\/radiol.2462070712","article-title":"Fleischner Society: glossary of terms for thoracic imaging","volume":"246","author":"Hansell","year":"2008","journal-title":"Radiology"},{"key":"2021061419592196300_ezaa457-B2","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1183\/09031936.00056612","article-title":"Correlation of radio- and histomorphological pattern of pulmonary adenocarcinoma","volume":"41","author":"Lederlin","year":"2013","journal-title":"Eur Respir J"},{"key":"2021061419592196300_ezaa457-B3","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1093\/ejcts\/ezy040","article-title":"The role of the ground-glass opacity ratio in resected lung adenocarcinoma","volume":"54","author":"Huang","year":"2018","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021061419592196300_ezaa457-B4","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/j.jtho.2016.03.025","article-title":"The IASLC Lung Cancer Staging Project: proposals for coding T categories for subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM Classification of Lung Cancer","volume":"11","author":"Travis","year":"2016","journal-title":"J Thorac Oncol"},{"key":"2021061419592196300_ezaa457-B5","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1148\/radiol.13130209","article-title":"Measurement of solid component in part-solid lesions with a mediastinal window setting?","volume":"268","author":"Arenas-Jim\u00e9nez","year":"2013","journal-title":"Radiology"},{"key":"2021061419592196300_ezaa457-B6","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/JTO.0000000000000019","article-title":"Correlation between the size of the solid component on thin-section CT and the invasive component on pathology in small lung adenocarcinomas manifesting as ground-glass nodules","volume":"9","author":"Lee","year":"2014","journal-title":"J Thorac Oncol"},{"key":"2021061419592196300_ezaa457-B7","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1148\/radiol.2017162894","article-title":"Recommendations for measuring pulmonary nodules at CT: a statement from the Fleischner Society","volume":"285","author":"Bankier","year":"2017","journal-title":"Radiology"},{"key":"2021061419592196300_ezaa457-B8","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1148\/radiol.2017170044","article-title":"Subsolid lung nodule classification: a CT criterion for improving interobserver agreement","volume":"286","author":"Revel","year":"2018","journal-title":"Radiology"},{"key":"2021061419592196300_ezaa457-B9","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1148\/radiol.2015142700","article-title":"Observer variability for classification of pulmonary nodules on low-dose CT images and its effect on nodule management","volume":"277","author":"van Riel","year":"2015","journal-title":"Radiology"},{"key":"2021061419592196300_ezaa457-B10","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.athoracsur.2019.03.041","article-title":"Which window setting is best for estimating pathologic invasive size and invasiveness?","volume":"108","author":"Samejima","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2021061419592196300_ezaa457-B11","doi-asserted-by":"crossref","first-page":"6069","DOI":"10.1007\/s00330-019-06216-6","article-title":"Clinical T categorization in stage IA lung adenocarcinomas: prognostic implications of CT display window settings for solid portion measurement","volume":"29","author":"Kim","year":"2019","journal-title":"Eur Radiol"},{"key":"2021061419592196300_ezaa457-B12","first-page":"176","volume-title":"Sample Size Tables for Clinical Studies","author":"Machin","year":"1997","edition":"2nd edn."},{"key":"2021061419592196300_ezaa457-B13","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"2021061419592196300_ezaa457-B14","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.2214\/ajr.178.5.1781053","article-title":"CT screening for lung cancer: frequency and significance of part-solid and nonsolid nodules","volume":"178","author":"Henschke","year":"2002","journal-title":"AJR Am J Roentgenol"},{"key":"2021061419592196300_ezaa457-B15","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.jtcvs.2011.10.037","article-title":"Prognostic significance of using solid versus whole tumor size on high-resolution computed tomography for predicting pathologic malignant grade of tumors in clinical stage IA lung adenocarcinoma: a multicenter study","volume":"143","author":"Tsutani","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021061419592196300_ezaa457-B16","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1093\/ejcts\/ezy225","article-title":"Which T descriptor is more predictive of recurrence after sublobar resection: whole tumour size versus solid component size?","volume":"54","author":"Su","year":"2018","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021061419592196300_ezaa457-B17","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1245\/s10434-015-4780-0","article-title":"Diameter of solid tumor component alone should be used to establish T stage in lung adenocarcinoma","volume":"22","author":"Burt","year":"2015","journal-title":"Ann Surg Oncol"},{"key":"2021061419592196300_ezaa457-B18","doi-asserted-by":"crossref","first-page":"327","DOI":"10.3816\/CLC.2007.n.012","article-title":"Prognostic value of tumor disappearance rate on computed tomography in advanced-stage lung adenocarcinoma","volume":"8","author":"Haraguchi","year":"2007","journal-title":"Clin Lung Cancer"},{"key":"2021061419592196300_ezaa457-B19","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1148\/radiol.2015150714","article-title":"Differentiating between subsolid and solid pulmonary nodules at CT: inter- and intraobserver agreement between experienced thoracic radiologists","volume":"278","author":"Ridge","year":"2016","journal-title":"Radiology"},{"key":"2021061419592196300_ezaa457-B20","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.lungcan.2016.02.017","article-title":"Estimation of the pathological invasive size of pulmonary adenocarcinoma using high-resolution computed tomography of the chest: a consideration based on lung and mediastinal window settings","volume":"95","author":"Sakakura","year":"2016","journal-title":"Lung Cancer"},{"key":"2021061419592196300_ezaa457-B21","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.athoracsur.2017.01.076","article-title":"Importance of ground glass opacity component in clinical stage IA radiologic invasive lung cancer","volume":"104","author":"Hattori","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"2021061419592196300_ezaa457-B22","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.jtho.2018.12.030","article-title":"Lung adenocarcinomas manifesting as radiological part-solid nodules define a special clinical subtype","volume":"14","author":"Ye","year":"2019","journal-title":"J Thorac Oncol"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ejcts\/article-pdf\/59\/6\/1295\/38622242\/ezaa457.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ejcts\/article-pdf\/59\/6\/1295\/38622242\/ezaa457.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T20:01:08Z","timestamp":1623700868000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/59\/6\/1295\/6041761"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,18]]},"references-count":22,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,12,18]]},"published-print":{"date-parts":[[2021,6,14]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezaa457","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,6,1]]},"published":{"date-parts":[[2020,12,18]]}}}