Ryutaro Kakinuma1,2,3, Yukio Muramatsu1,4, Junta Yamamichi1,5, Shiho Gomi1,6, Estanislao Oubel7, Noriyuki Moriyama1,8. 1. Division of Cancer Screening, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan. 2. Cancer Screening Center, National Cancer Center, Tokyo, Japan. 3. Department of Pulmonology, Tokyo General Hospital, Tokyo, Japan. 4. Department of Radiology, E-Medical Tokyo, Tokyo, Japan. 5. Global Healthcare IT Project, Medical Equipment Group, Canon Inc., Tokyo, Japan. 6. Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan. 7. MEDIAN Technologies, Valbonne Sophia Antipolis, Valbonne, France. 8. Department of Radiology, Tokyo Midtown Medical Center, Tokyo, Japan.
Abstract
BACKGROUND: This study sought to evaluate the 95% limits of agreement of the volumes of 5-year clinically stable solid nodules for the development of a follow-up system for indeterminate solid nodules. METHODS: The volumes of 226 solid nodules that had been clinically stable for 5 years were measured in 186 patients (53 female never-smokers, 36 male never-smokers, 51 males with <30 pack-years, and 46 males with ≥30 pack-years) using a three-dimensional semiautomated method. Volume changes were evaluated using three methods: percent change, proportional change and growth rate. The 95% limits of agreement were evaluated using the Bland-Altman method. RESULTS: The 95% limits of agreement were as follows: range of percent change, from ±34.5% to ±37.8%; range of proportional change, from ±34.1% to ±36.8%; and range of growth rate, from ±39.2% to ±47.4%. Percent change-based, proportional change-based, and growth rate-based diagnoses of an increase or decrease in ten solid nodules were made at a mean of 302±402, 367±455, and 329±496 days, respectively, compared with a clinical diagnosis made at 809±616 days (P<0.05). CONCLUSIONS: The 95% limits of agreement for volume change in 5-year stable solid nodules may enable the detection of an increase or decrease in the solid nodule at an earlier stage than that enabled by a clinical diagnosis, possibly contributing to the development of a follow-up system for reducing the number of additional Computed tomography (CT) scans performed during the follow-up period.
BACKGROUND: This study sought to evaluate the 95% limits of agreement of the volumes of 5-year clinically stable solid nodules for the development of a follow-up system for indeterminate solid nodules. METHODS: The volumes of 226 solid nodules that had been clinically stable for 5 years were measured in 186 patients (53 female never-smokers, 36 male never-smokers, 51 males with <30 pack-years, and 46 males with ≥30 pack-years) using a three-dimensional semiautomated method. Volume changes were evaluated using three methods: percent change, proportional change and growth rate. The 95% limits of agreement were evaluated using the Bland-Altman method. RESULTS: The 95% limits of agreement were as follows: range of percent change, from ±34.5% to ±37.8%; range of proportional change, from ±34.1% to ±36.8%; and range of growth rate, from ±39.2% to ±47.4%. Percent change-based, proportional change-based, and growth rate-based diagnoses of an increase or decrease in ten solid nodules were made at a mean of 302±402, 367±455, and 329±496 days, respectively, compared with a clinical diagnosis made at 809±616 days (P<0.05). CONCLUSIONS: The 95% limits of agreement for volume change in 5-year stable solid nodules may enable the detection of an increase or decrease in the solid nodule at an earlier stage than that enabled by a clinical diagnosis, possibly contributing to the development of a follow-up system for reducing the number of additional Computed tomography (CT) scans performed during the follow-up period.
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