PURPOSE: To determine if the degree of enhancement of pulmonary nodules is directly related to the likelihood of malignancy and to the vascularity of the nodule. MATERIALS AND METHODS: Uncalcified 6-40-mm-diameter pulmonary nodules were studied in 163 patients with malignant neoplasm (n = 111), granuloma (n = 43), and benign neoplasm (n = 9). Serial thin-section computed tomography (CT) was performed before and after injection of 100 mL of nonionic contrast material at 2 mL/sec. The maximum level of enhancement was recorded. Eighteen histologic specimens were graded after vascular staining. RESULTS: Malignant neoplasms enhanced (median, 40.0 HU; range, 20-108 HU) significantly more than granulomas and benign neoplasms (median, 12.0 HU; range, -4 to 58 HU) (P < .001). With 20 HU as the threshold for a positive test, sensitivity was 100%; specificity, 76.9%; positive predictive value, 90.2%; negative predictive value, 100%; and accuracy, 92.6% (prevalence of malignancy, 68.1%). Degree of enhancement was significantly related to amount of central vascular staining (P = .003). CONCLUSION: Enhancement is an indicator of malignancy and vascularity.
PURPOSE: To determine if the degree of enhancement of pulmonary nodules is directly related to the likelihood of malignancy and to the vascularity of the nodule. MATERIALS AND METHODS: Uncalcified 6-40-mm-diameter pulmonary nodules were studied in 163 patients with malignant neoplasm (n = 111), granuloma (n = 43), and benign neoplasm (n = 9). Serial thin-section computed tomography (CT) was performed before and after injection of 100 mL of nonionic contrast material at 2 mL/sec. The maximum level of enhancement was recorded. Eighteen histologic specimens were graded after vascular staining. RESULTS:Malignant neoplasms enhanced (median, 40.0 HU; range, 20-108 HU) significantly more than granulomas and benign neoplasms (median, 12.0 HU; range, -4 to 58 HU) (P < .001). With 20 HU as the threshold for a positive test, sensitivity was 100%; specificity, 76.9%; positive predictive value, 90.2%; negative predictive value, 100%; and accuracy, 92.6% (prevalence of malignancy, 68.1%). Degree of enhancement was significantly related to amount of central vascular staining (P = .003). CONCLUSION: Enhancement is an indicator of malignancy and vascularity.
Authors: D R Baldwin; T Eaton; J Kolbe; T Christmas; D Milne; J Mercer; E Steele; J Garrett; M L Wilsher; A U Wells Journal: Thorax Date: 2002-09 Impact factor: 9.139
Authors: L Cardinale; F Ardissone; S Novello; M Busso; F Solitro; M Longo; D Sardo; M Giors; C Fava Journal: Radiol Med Date: 2009-05-29 Impact factor: 3.469
Authors: Thomas Henzler; Jingyun Shi; Hashim Jafarov; Stefan O Schoenberg; Christian Manegold; Christian Fink; Gerald Schmid-Bindert Journal: Transl Lung Cancer Res Date: 2012-03
Authors: G Schmid-Bindert; Thomas Henzler; T Q Chu; M Meyer; J W Nance; U J Schoepf; D J Dinter; P Apfaltrer; R Krissak; C Manegold; S O Schoenberg; C Fink Journal: Eur Radiol Date: 2011-08-07 Impact factor: 5.315