Article

Computer-aided volumetry of pulmonary nodules exhibiting ground-glass opacity at MDCT.

Department of Diagnostic Radiology, Kumamoto University, Japan.
American Journal of Roentgenology (Impact Factor: 2.9). 02/2010; 194(2):398-406. DOI:10.2214/AJR.09.2583
Source: PubMed

ABSTRACT The purpose of this study was to investigate the accuracy and reproducibility of results acquired with computer-aided volumetry software during MDCT of pulmonary nodules exhibiting ground-glass opacity.
To evaluate the accuracy of computer-aided volumetry software, we performed thin-section helical CT of a chest phantom that included simulated 3-, 5-, 8-, 10-, and 12-mm-diameter ground-glass opacity nodules with attenuation of -800, -630, and -450 HU. Three radiologists measured the volume of the nodules and calculated the relative volume measurement error, which was defined as follows: (measured nodule volume minus assumed nodule volume / assumed nodule volume) x 100. Two radiologists performed two independent measurements of 59 nodules in humans. Intraobserver and interobserver agreement was evaluated with Bland-Altman methods.
The relative volume measurement error for simulated ground-glass opacity nodules measuring 3 mm ranged from 51.1% to 85.2% and for nodules measuring 5 mm or more in diameter ranged from -4.1% to 7.1%. In the clinical study, for intraobserver agreement, the 95% limits of agreement were -14.9% and -13.7% and -16.6% to 15.7% for observers A and B. For interobserver agreement, these values were -16.3% to 23.7% for nodules 8 mm in diameter or larger.
With computer-aided volumetry of ground-glass opacity nodules, the relative volume measurement error was small for nodules 5 mm in diameter or larger. Intraobserver and interobserver agreement was relatively high for nodules 8 mm in diameter or larger.

0 0
 · 
0 Bookmarks
 · 
83 Views
  • [show abstract] [hide abstract]
    ABSTRACT: Pulmonary nodules with ground-glass opacity (GGO) are frequently encountered; there is little consensus on appropriate monitoring of them. The purpose of this study was to clarify which baseline clinical and radiological characteristics were associated with growth of these nodules. We retrospectively studied patients with pulmonary nodules that met the following criteria: (1) lesion diameter of ≤3cm, (2) GGO proportion of ≥50%, and (3) observation without treatment in the prior 6 months. Between 1999 and 2013, 120 pulmonary lesions in 67 patients fulfilled inclusion criteria. We evaluated changes in lesion size on serial computed tomography. Two endpoints, "time to 2-mm growth" and "incidence of 2-mm growth", were analyzed using Cox proportional hazards and logistic regression models, respectively. At the median observation period of 4.2 years, 34 lesions exhibited growth by ≥2mm, whereas 86 remained unchanged. Smoking history and initial lesion diameter were statistically significant variables in both time-to-event and regression analyses. Hazard ratio (HR) for smoking history was 3.67 (P<0.01). Compared with those ≤1cm, HRs for 1.1-2cm and 2.1-3cm lesions were 2.23 (P=0.08) and 5.08 (P=0.04), respectively. Odds ratio (OR) for smoking history was 6.51 (P<0.01); OR for lesion diameter of 1.1-3cm (versus ≤1cm) was 4.06 (P=0.02). Smoking history and initial lesion diameter are robustly associated with GGO growth. These results suggest that large GGOs, especially in smokers, warrant close follow-up to accurately monitor lesion growth.
    Lung cancer (Amsterdam, Netherlands) 11/2013; · 3.14 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: In this review, we focus on the radiologic, clinical, and pathologic aspects primarily of solitary subsolid pulmonary nodules. Particular emphasis will be placed on the pathologic classification and correlative computed tomography (CT) features of adenocarcinoma of the lung. The capabilities of fluorodeoxyglucose positron emission tomography-CT and histologic sampling techniques, including CT-guided biopsy, endoscopic-guided biopsy, and surgical resection, are discussed. Finally, recently proposed management guidelines by the Fleischner Society and the American College of Chest Physicians are reviewed.
    Radiologic Clinics of North America 01/2014; 52(1):47-67. · 1.95 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Lung nodules are commonly found on computed tomography (CT) and need a standardized approach in order to avoid misdiagnosing lung cancer and delaying surgical excision whilst simultaneously avoiding unnecessary invasive procedures if the lesions prove to be benign. Great advances have been made in the last decade in various areas affecting the management of lung nodules: the understanding of the molecular mechanisms behind carcinogenesis, a new classification of lung adenocarcinoma, new data on lung cancer screening, widespread use of multi-detector row CT and development of volumetric analysis software for nodules. Recent decision-making algorithms are based on the size, density and follow-up of the nodule. The distinction between solid nodules, sub-solid nodules and pure ground glass nodules is fundamental, and has a strong correlation with the histologic spectrum of adenocarcinoma. In the absence of criteria suggesting benign disease, the radiologist's report should offer one of the following two options: follow-up based on the recommendations if the nodule is equivocal, or multidisciplinary discussion to consider invasive management if the nodule is highly suspicious of malignancy. Recent data from this statement are reviewed and practical guidelines are offered based on international expert consensus opinion.
    Diagnostic and interventional imaging. 09/2013;