Can CT imaging features of ground‐glass opacity predict invasiveness? A meta‐analysis

Background A meta‐analysis was conducted to investigate the diagnostic performance of computed tomography (CT) imaging features of ground‐glass opacity (GGO) to predict invasiveness. Methods Two reviewers independently searched PubMed, Medline, Web of Science, Cochrane Embase and CNKI for relevant studies. CT imaging signs of bubble lucency, speculation, lobulated margin, and pleural indentation were used as diagnostic references to discriminate pre‐invasive and invasive disease. The sensitivity, specificity, diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curves, and the area under the SROC curve (AUC) were calculated to evaluate diagnostic efficiency. Results Twelve studies were finally included. Diagnostic performance ranged from 0.41 to 0.52 for sensitivity and 0.56 to 0.63 for specificity. The diagnostic positive and negative likelihood ratios ranged from 1.03 to 2.13 and 0.52 to 1.05, respectively. The DORs of the GGO CT features for discriminating invasive disease ranged from 1.02 to 4.00. The area under the ROC curve was also low, with a range of 0.60 to 0.67 for discriminating pre‐invasive and invasive disease. Conclusion The diagnostic value of a single CT imaging sign of GGO, such as bubble lucency, speculation, lobulated margin, or pleural indentation is limited for discriminating pre‐invasive and invasive disease because of low sensitivity, specificity, and AUC.