BACKGROUND: A solitary pulmonary nodule (SPN) may represent early stage lung cancer. Lung cancer is a devastating disease with an overall 5-year mortality rate of approximately 84% but with early detection and surgery as low as 47%. Currently a contrast-enhanced multiple-row detector CT (MDCT) scan is the first examination when evaluating patients with suspected lung cancer. PURPOSE: To apply an additional high resolution CT (HRCT) to SPNs to test whether certain morphological characteristics are associated with malignancy, to assess the diagnostic accuracy of HRCT in the characterization of SPNs, and to address the reproducibility of all measures. MATERIAL AND METHOD: Two hundred and thirteen participants with SPNs were included in a follow-up study. Blinded HRCT images were assessed with regard to margin risk categories (MRCs), calcification patterns and certain other characteristics and overall malignancy potential ratings (MPRs) were given. Morphological characteristics were tested against reference standard and ROC methodology was applied to assess diagnostic accuracy. Reproducibility was measured with Kappa statistics and 95% confidence intervals were computed for all results. Histopathology (90%) and CT follow-up (10%) were used as reference standard. RESULTS: MRCs (P < 0.001), calcification patterns (P = 0.003), and pleural retraction (P < 0.001) were all statistically significantly associated to malignancy. Reproducibility was moderate to substantial. Sensitivity, specificity, and overall diagnostic accuracy of HRCT were 98%, 23% and 87%, respectively. Reproducibility was substantial. CONCLUSION: Statistically significant associations between SPN MRCs, calcification patterns, pleural retraction and malignancy were found. HRCT yielded a very high sensitivity and a somewhat lower specificity for malignancy. Reproducibility was high.
BACKGROUND: A solitary pulmonary nodule (SPN) may represent early stage lung cancer. Lung cancer is a devastating disease with an overall 5-year mortality rate of approximately 84% but with early detection and surgery as low as 47%. Currently a contrast-enhanced multiple-row detector CT (MDCT) scan is the first examination when evaluating patients with suspected lung cancer. PURPOSE: To apply an additional high resolution CT (HRCT) to SPNs to test whether certain morphological characteristics are associated with malignancy, to assess the diagnostic accuracy of HRCT in the characterization of SPNs, and to address the reproducibility of all measures. MATERIAL AND METHOD: Two hundred and thirteen participants with SPNs were included in a follow-up study. Blinded HRCT images were assessed with regard to margin risk categories (MRCs), calcification patterns and certain other characteristics and overall malignancy potential ratings (MPRs) were given. Morphological characteristics were tested against reference standard and ROC methodology was applied to assess diagnostic accuracy. Reproducibility was measured with Kappa statistics and 95% confidence intervals were computed for all results. Histopathology (90%) and CT follow-up (10%) were used as reference standard. RESULTS: MRCs (P < 0.001), calcification patterns (P = 0.003), and pleural retraction (P < 0.001) were all statistically significantly associated to malignancy. Reproducibility was moderate to substantial. Sensitivity, specificity, and overall diagnostic accuracy of HRCT were 98%, 23% and 87%, respectively. Reproducibility was substantial. CONCLUSION: Statistically significant associations between SPN MRCs, calcification patterns, pleural retraction and malignancy were found. HRCT yielded a very high sensitivity and a somewhat lower specificity for malignancy. Reproducibility was high.
Authors: Darragh F Halpenny; Gregory J Riely; Sara Hayes; Helena Yu; Junting Zheng; Chaya S Moskowitz; Michelle S Ginsberg Journal: Lung Cancer Date: 2014-09-17 Impact factor: 5.705
Authors: Michael K Gould; Jessica Donington; William R Lynch; Peter J Mazzone; David E Midthun; David P Naidich; Renda Soylemez Wiener Journal: Chest Date: 2013-05 Impact factor: 9.410
Authors: Annemie Snoeckx; Pieter Reyntiens; Damien Desbuquoit; Maarten J Spinhoven; Paul E Van Schil; Jan P van Meerbeeck; Paul M Parizel Journal: Insights Imaging Date: 2017-11-15
Authors: Stefan Walbom Harders; Hans Henrik Madsen; Karin Hjorthaug; Anne Kirstine Arveschoug; Torben Riis Rasmussen; Peter Meldgaard; Johanne Bach Andersen; Hans Kristian Pilegaard; Henrik Hager; Michael Rehling; Finn Rasmussen Journal: Cancer Imaging Date: 2012-10-16 Impact factor: 3.909