Abstract
BACKGROUND: The role of the lesion-vessel relationship in neoplastic and non-neoplastic ground-glass nodules (GGNs) remains unclear. Thus, this study aimed to investigate the spatial relationship between lesions and vessels of different diameters for differentiating and evaluating GGNs. METHODS: Between January 2019 and September 2023, a total of 1,038 patients with 531 neoplastic GGNs and 531 non-neoplastic GGNs were retrospectively examined. The lesion-vessel spatial relationship was classified into three types: adherence (type I), where a nearby vessel is in contact with the margin of a GGN; surrounding (type II), where the GGN encircles the vessel; and combined (type III). The clinical data, computed tomography (CT) features, and lesion-vessel relationships concerning varying vessel diameters for different GGNs were summarized and compared. RESULTS: Type I and II relationships were more prevalent in non-neoplastic and neoplastic GGNs, respectively (P<0.001). The independent predictors of neoplastic GGNs were type II relationship [odds ratio (OR) 5.011; 95% confidence interval (CI): 2.753-9.124; P<0.001], surrounding vessels ≥1 but <2 mm (OR 2.497; 95% CI: 1.519-4.106; P<0.001), and surrounding vessels ≥2 mm (OR 8.375; 95% CI: 2.574-27.244; P<0.001); meanwhile, adherence to vessels ≥2 mm predicted non-neoplastic GGNs (OR 13.082; 95% CI: 3.826-44.737; P<0.001). The area under the curve of this model for predicting neoplastic GGNs was 0.878 (P<0.001). The proportions of neoplastic GGNs surrounding vessels ≥1 but <2 mm (49.6% to 72.6%) and ≥2 mm (5.8% to 36.0%) significantly increased with greater invasiveness (P<0.05). CONCLUSIONS: GGNs surrounding vessels ≥1 mm are more likely to be neoplastic, with those surrounding larger vessels indicating a greater likelihood of invasiveness, while lesions adhering to vessels ≥2 mm are more likely to be non-neoplastic.