Coronal multiplanar reconstruction view from whole lung thin-section CT by multidetector-row CT: determination of malignant or benign lesions and differential diagnosis in 68 cases of solitary pulmonary nodule.

PURPOSE The purpose of this study was to evaluate the usefulness of the coronal multiplanar reconstruction (MPR) view in comparison with transverse helical thin-section CT for both the determination of malignant or benign lesions and the differential diagnosis of solitary pulmonary nodules. MATERIALS AND METHODS Sixty-eight cases of pathologically proved solitary pulmonary nodule less than 3 cm in diameter were enrolled in this study. For the routine study, transverse helical thin-section CT (1.25 mm collimation, FOV 20 cm) covering the areas with solitary pulmonary nodules as well as whole lung helical thin-section CT (2.5 mm collimation, 1.25 mm reconstruction interval, FOV 34.5 cm, pitch 6:1, high-spatial frequency algorithm) were scanned with a multidetector-row CT (MDCT) scanner. From the whole lung thin-section CT data, coronal MPR views (2.5 mm slice thickness) were reconstructed on a workstation. ROC analysis was used for an observer performance study, in which three observers indicated their confidence level for the determination of malignant or benign lesion for the nodules by means of transverse thin-section CT and coronal MPR. In addition, the observers recorded appropriate disease entities as the final diagnosis of each case. Accuracies of the final diagnosis based on the two sets of images were compared with McNemer' s test. RESULTS In terms of the determination of malignant or benign lesion, there was no significant difference between the two sets of images (coronal MPR and transverse thin-section CT; mean Az=0.853 and 0.854, respectively). In addition, accuracy of the final diagnosis based on coronal MPR views (74%) was almost equal to that based on transverse thin-section CT (71%) (p=0.3). CONCLUSIONS The diagnostic efficacy of the coronal MPR view is comparable to that of transverse thin-section CT for the evaluation of solitary pulmonary nodules.

[1]  W. Webb.  The pleural tail sign. , 1978, Radiology.

[2]  E A Zerhouni,et al.  CT of the solitary pulmonary nodule. , 1980, AJR. American journal of roentgenology.

[3]  J. Hanley,et al.  The meaning and use of the area under a receiver operating characteristic (ROC) curve. , 1982, Radiology.

[4]  E. Fishman,et al.  Pulmonary hamartoma: CT findings. , 1986, Radiology.

[5]  S S Sagel,et al.  CT of the pulmonary nodule: a cooperative study. , 1986, Radiology.

[6]  E. Fishman,et al.  Solitary pulmonary nodules: CT assessment. , 1986, Radiology.

[7]  C E Metz,et al.  Some practical issues of experimental design and data analysis in radiological ROC studies. , 1989, Investigative radiology.

[8]  M Fujita,et al.  Prevalence of air bronchograms in small peripheral carcinomas of the lung on thin-section CT: comparison with benign tumors. , 1991, AJR. American journal of roentgenology.

[9]  N. Müller,et al.  Solitary pulmonary nodule: high-resolution CT and radiologic-pathologic correlation. , 1991, Radiology.

[10]  H E Rockette,et al.  The use of continuous and discrete confidence judgments in receiver operating characteristic studies of diagnostic imaging techniques. , 1992, Investigative radiology.

[11]  K Murata,et al.  Pulmonary metastatic nodules: CT-pathologic correlation. , 1992, Radiology.

[12]  H Nakata,et al.  Appearance of pulmonary metastases on high-resolution CT scans: comparison with histopathologic findings from autopsy specimens. , 1993, AJR. American journal of roentgenology.

[13]  J. Ikezoe,et al.  Focal organizing pneumonia: CT appearance. , 1993, Radiology.

[14]  K. Taguchi,et al.  Algorithm for image reconstruction in multi-slice helical CT. , 1998, Medical physics.

[15]  K Kuriyama,et al.  Ground-glass opacity on thin-section CT: value in differentiating subtypes of adenocarcinoma of the lung. , 1999, AJR. American journal of roentgenology.

[16]  S Schaller,et al.  Subsecond multi-slice computed tomography: basics and applications. , 1999, European journal of radiology.

[17]  C. Pistitsch,et al.  Usefulness of morphological characteristics for the differentiation of benign from malignant solitary pulmonary lesions using HRCT , 1999, European Radiology.

[18]  H Hu,et al.  Multi-slice helical CT: scan and reconstruction. , 1999, Medical physics.

[19]  H. Soeda,et al.  New Classification of Small Pulmonary Nodules by Margin Characteristics on Highresolution CT , 1999, Acta radiologica.

[20]  W D Foley,et al.  Four multidetector-row helical CT: image quality and volume coverage speed. , 2000, Radiology.

[21]  K. S. Lee,et al.  Quantification of ground-glass opacity on high-resolution CT of small peripheral adenocarcinoma of the lung: pathologic and prognostic implications. , 2001, AJR. American journal of roentgenology.

[22]  High-resolution CT using multidetector CT equipment: evaluation of image quality in 11 cadaveric lungs and a phantom. , 2001, AJR. American journal of roentgenology.