American Journal of Roentgenology, Vol 169, 1611-1614, Copyright © 1997 by American Roentgen Ray Society

ARTICLES

Detection of pulmonary nodules with helical CT: comparison of cine and film-based viewing

M Tillich, F Kammerhuber, P Reittner, T Riepl, G Stoeffler and DH Szolar
Department of Radiology, Karl-Franzens University Graz, Austria.

OBJECTIVE: The purpose of our study was to determine whether cine viewing of helical CT scans of the chest improves the detection of pulmonary nodules in patients with known extrathoracic malignancy. SUBJECTS AND METHODS: Identical helical CT studies of the chest of 60 patients with known extrathoracic malignancy were reviewed for detection of pulmonary nodules. Four radiologists interpreted the helical CT studies. Pulmonary nodules were divided into four groups according to maximum diameter: group 1, nodules smaller than or equal to 5 mm; group 2, nodules larger than 5 mm but smaller than or equal to 10 mm; group 3, nodules larger than 10 mm but smaller than or equal to 20 mm; group 4, nodules larger than 20 mm. Interpreters also assigned a lesion conspicuity score of pulmonary nodules based on a four-point scale: one point for poor visibility, two points for adequate visibility, three points for good visibility, and four points for excellent visibility. Static film-based images printed on a laser printer were viewed on a light box. Cine viewing of helical CT scans from the same examinations was done on a commercially available workstation. The number, diameter, and conspicuity scores of pulmonary nodules detected at lung window settings were documented. RESULTS: Interpreters saw 266 nodules on cine viewing, whereas 237 nodules were seen with static film-based viewing. A significantly higher percentage of nodules that were smaller than or equal to 5 mm in diameter was found with cine viewing (n = 106) than with static film-based viewing (n = 81) (p < .05). Cine viewing (n = 105) also allowed a slightly but not significantly higher detection rate of nodules that were larger than 5 mm but smaller than or equal to 10 mm in diameter than did static film-based viewing (n = 101). We found no differences between cine (n = 55) and static film-based viewing (n = 55) in the detection of pulmonary nodules that were larger than 10 mm in diameter. The mean conspicuity score of nodules was significantly higher with cine viewing (2.9 +/- 0.2) than with film-based viewing (2.4 +/- 0.2) (p < .05). CONCLUSION: Cine viewing of helical CT scans significantly increases the detection rate of pulmonary nodules that are smaller than or equal to 5 mm in diameter. However, we found no significant difference between cine and film-based viewing in the detection rate of pulmonary nodules that were larger than 5 mm in diameter. The advantages of cine viewing may be attributed to both the larger image size and the ability to scroll through images for improved differentiation between vessels and nodules.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S Khokhar, A Vickers, M S Moore, S Mironov, D E Stover, and M B Feinstein Significance of non-calcified pulmonary nodules in patients with extrapulmonary cancers Thorax, April 1, 2006; 61(4): 331 - 336. [Abstract] [Full Text] [PDF]

				F. Li, H. Arimura, K. Suzuki, J. Shiraishi, Q. Li, H. Abe, R. Engelmann, S. Sone, H. MacMahon, and K. Doi Computer-aided Detection of Peripheral Lung Cancers Missed at CT: ROC Analyses without and with Localization Radiology, November 1, 2005; 237(2): 684 - 690. [Abstract] [Full Text] [PDF]

				Y. J. Kim, J. K. Han, S. H. Kim, J. Y. Jeong, S. K. An, C. J. Han, K.-R. Son, K. H. Lee, J. M. Lee, and B. I. Choi Small-Bowel Obstruction in a Phantom Model of ex Vivo Porcine Intestine: Comparison of PACS Stack and Tile Modes for CT Interpretation Radiology, September 1, 2005; 236(3): 867 - 871. [Abstract] [Full Text] [PDF]

				C. D. Johnson Hard- versus Soft-Copy Interpretation Radiology, June 1, 2003; 227(3): 629 - 630. [Full Text] [PDF]

				M. E. J. Pijl, M. N. J. M. Wasser, E. C. Joekes, C. J. H. van de Velde, and J. L. Bloem Metastases of Colorectal Carcinoma: Comparison of Soft- and Hard-Copy Helical CT Interpretation Radiology, June 1, 2003; 227(3): 747 - 751. [Abstract] [Full Text] [PDF]

				M. S. Ginsberg, J. Oh, A. Welber, and D. M. Panicek Clinical Usefulness of Imaging Performed After CT Angiography That Was Negative for Pulmonary Embolus in a High-Risk Oncologic Population Am. J. Roentgenol., November 1, 2002; 179(5): 1205 - 1208. [Abstract] [Full Text] [PDF]

				J. F. Gruden, S. Ouanounou, S. Tigges, S. D. Norris, and T. S. Klausner Incremental Benefit of Maximum-Intensity-Projection Images on Observer Detection of Small Pulmonary Nodules Revealed by Multidetector CT Am. J. Roentgenol., July 1, 2002; 179(1): 149 - 157. [Abstract] [Full Text] [PDF]

				N. Hollings and P. Shaw Diagnostic imaging of lung cancer Eur. Respir. J., April 1, 2002; 19(4): 722 - 742. [Abstract] [Full Text] [PDF]

				S. J. SWENSEN, J. R. JETT, J. A. SLOAN, D. E. MIDTHUN, T. E. HARTMAN, A.-M. SYKES, G. L. AUGHENBAUGH, F. E. ZINK, S. L. HILLMAN, G. R. NOETZEL, et al. Screening for Lung Cancer with Low-Dose Spiral Computed Tomography Am. J. Respir. Crit. Care Med., February 15, 2002; 165(4): 508 - 513. [Abstract] [Full Text] [PDF]

				P. M. Boiselle, A. Ernst, and D. D. Karp Lung Cancer Detection in the 21st Century: Potential Contributions and Challenges of Emerging Technologies Am. J. Roentgenol., November 1, 2000; 175(5): 1215 - 1221. [Full Text] [PDF]