Short-term quantitative CT changes in synchronous ground-glass nodules during immune checkpoint inhibitor therapy in patients with lung cancer

BackgroundImmune checkpoint inhibitors (ICIs) have improved survival in patients with lung cancer, leading to more frequent detection of synchronous ground-glass nodules (GGNs) during follow-up. This study aimed to evaluate short-term longitudinal quantitative CT changes of synchronous GGNs in lung cancer patients receiving ICI therapy.MethodsIn this retrospective matched cohort study, we included 90 patients with lung cancers harboring 110 synchronous GGNs receiving 3–4 cycles of ICIs, and compared them with a matched cohort of incidentally detected pulmonary GGNs without any therapy.

Baseline and follow-up chest CT scans were quantitatively analyzed to capture changes of diameter, volume, surface area, mass, mean CT attenuation, standard deviation of CT attenuation, solid component proportion, sphericity, energy and entropy. Volume change proportion (VCP) was assessed to define nodule response, using ± 25% as the threshold.

Subgroup analyses were conducted according to nodule density and Lung-RADS category.ResultsVCP showed that nodules in ICI group were more likely to show regression than those in the control group (23.6% vs. 1.8%, p< 0.001).