Yang Y, Li K, Sun D, et al. - Thirty-nine patients with 53 pure ground-glass nodules (pGGNs) who underwent enhanced dual-source dual-energy CT (DECT) were involved in a study by the experts with an intend to examine the potentials of enhanced DECT and three-planar measurements for distinguishing invasive pulmonary adenocarcinomas (IPAs) from preinvasive lesions seeming as pGGNs. For traditional CT features, Important variations between preinvasive lesions and IPAs were exhibited by only lesion size and unenhanced CT attenuation value. On virtual images, the so­called “virtual HU” or “VHU,” and the modified normalized iodine concentration (NIC), preinvasive lesions and IPAs showed notable variations in attenuation, and both intra- and interobserver agreement for the quantitative measurements were great. Multivariate logistic regression analysis exhibited that important differentiators of IPAs from preinvasive lesions were larger lesion size and higher modified NIC. ROC curve analysis revealed that in order to differentiate IPAs from preinvasive lesions, modified NIC demonstrated excellent performance and significantly greater performance than lesion size. Therefore, in pGGNs, a lesion with a modified NIC value of more than 0.29 can be a very precise discriminator of IPAs from preinvasive lesions, and IPAs can be correctly and reliably distinguished from preinvasive lesions using enhanced dual-source DECT and three-planar measurements.