Radiological diagnostics of the malignant nature of ground glass opacity lesions in the lungs

Ground glass opacity (GGO) foci are a frequent finding on chest computed tomography (CT) scans. These foci may indicate various diseases, including lung cancer (LC), necessitating differential diagnosis of the nature of the changes. The aim of the study was to develop a diagnostic complex of radiological signs that would indicate with high accuracy malignant lung neoplasms in patients with GGO signs on chest CT and magnetic resonance imaging (MRI) scans. Methods. Chest CT (n = 72) and MRI (n = 11) data were analyzed in patients with and without clinical manifestations of acute or chronic lung diseases and with GGO in the lungs. Results. The analysis allowed us to establish the frequency of structural features of benign and malignant GGO foci, which were used to identify 3 GGO groups: predominantly benign, malignant, and of uncertain nature. The most significant predictors of pulmonary leukemia were a multinodular structure, the presence of a soft tissue component (STC) with contrast agent (CA) accumulation, deformed bronchial and vascular structures, and peribronchovascular localization. The probability of malignancy during the initial CT examination (monitoring) was 95%. CT data were supplemented by MRI, which revealed decreased diffusion and CA accumulation in the GGO lesion. Conclusion. CT allows to identify malignancy of the GGO foci in the lungs with high accuracy. Dynamic CT monitoring is essential to clarify the nature of the GGO. The main CT signs of GGO malignancy are multinodular structure, CA accumulation in the GGO area, vacuoles, deformed bronchial and vascular structures, and spicules. MRI is used as an additional method for clarifying the nature of the MS foci in complex cases.

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