Pulmonary nodules: detection, assessment, and CAD.

OBJECTIVE The imaging of pulmonary nodules is an evolving and dynamic field. In this review, we discuss the detection and multitechnique characterization of pulmonary nodules, emphasizing the impact of technological advances on both noninvasive and invasive evaluation and surveillance. The potential contribution of MRI, evolving imaging-guided techniques, and computer applications are also discussed. CONCLUSION Advances in MDCT and PET and the potential contribution of fast-imaging MRI sequences and computer applications should continue to improve our evaluation of the solitary pulmonary nodule.

[1]  Thomas H. Helbich,et al.  Evaluation of solitary pulmonary nodules with dynamic contrast-enhanced MR imaging--a promising technique. , 1995, Magnetic Resonance Imaging.

[2]  Lubomir M. Hadjiiski,et al.  Computer-aided diagnosis of pulmonary nodules on CT scans: segmentation and classification using 3D active contours. , 2006, Medical physics.

[3]  H MacMahon,et al.  Improvement in detection of pulmonary nodules: digital image processing and computer-aided diagnosis. , 2000, Radiographics.

[4]  Ehsan Samei,et al.  Recent advances in chest radiography. , 2006, Radiology.

[5]  S Sone,et al.  High-resolution CT analysis of small peripheral lung adenocarcinomas revealed on screening helical CT. , 2001, AJR. American journal of roentgenology.

[6]  B. Ginneken Computer-Aided Diagnosis in Thoracic Computed Tomography , 2008 .

[7]  M. Giger,et al.  Computerized Detection of Pulmonary Nodules in Computed Tomography Images , 1994, Investigative radiology.

[8]  P. Grenier,et al.  Computer-aided detection of solid lung nodules on follow-up MDCT screening: evaluation of detection, tracking, and reading time. , 2007, AJR. American journal of roentgenology.

[9]  B. Wang,et al.  Quantitative diagnosis of fatty liver with dual-energy CT: An experimental study in rabbits , 2003, Acta radiologica.

[10]  K. Doi,et al.  Computer-aided diagnosis in chest radiography: results of large-scale observer tests at the 1996-2001 RSNA scientific assemblies. , 2003, Radiographics : a review publication of the Radiological Society of North America, Inc.

[11]  Kenji Suzuki,et al.  Intrapulmonary Lymph Nodes: Thin-Section CT Features of 19 Nodules , 2002, Journal of computer assisted tomography.

[12]  K. Doi,et al.  Computer-aided detection of peripheral lung cancers missed at CT: ROC analyses without and with localization. , 2005, Radiology.

[13]  Stefan Tigges,et al.  Incremental benefit of maximum-intensity-projection images on observer detection of small pulmonary nodules revealed by multidetector CT. , 2002, AJR. American journal of roentgenology.

[14]  Sandy Napel,et al.  Registration of lung nodules using a semi-rigid model: method and preliminary results. , 2007, Medical physics.

[15]  J. Austin,et al.  Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society. , 2005, Radiology.

[16]  Martin Fiebich,et al.  Automatic detection of pulmonary nodules at spiral CT: clinical application of a computer-aided diagnosis system , 2002, European Radiology.

[17]  J. Remy,et al.  Electromagnetic navigation diagnostic bronchoscopy for small peripheral lung lesions , 2007, European Respiratory Journal.

[18]  S. Armato,et al.  Computerized detection of pulmonary nodules on CT scans. , 1999, Radiographics : a review publication of the Radiological Society of North America, Inc.

[19]  P. Buell,et al.  Asymptomatic solitary pulmonary nodules. Host survival, tumor size, and growth rate. , 1973, The Journal of thoracic and cardiovascular surgery.

[20]  Masumi Kadoya,et al.  High-Resolution CT Features: Prognostic Significance in Peripheral Lung Adenocarcinoma with Bronchioloalveolar Carcinoma Components , 2003, Respiration.

[21]  Stephen J. Swensen,et al.  CT Reconstruction Algorithm Selection in the Evaluation of Solitary Pulmonary Nodules , 1995, Journal of computer assisted tomography.

[22]  M. McNitt-Gray,et al.  Patient-specific models for lung nodule detection and surveillance in CT images , 2001, IEEE Transactions on Medical Imaging.

[23]  L. Washington,et al.  Inherent variability of CT lung nodule measurements in vivo using semiautomated volumetric measurements. , 2006, AJR. American journal of roentgenology.

[24]  C I Henschke,et al.  Special techniques in transthoracic needle biopsy of pulmonary nodules. , 2000, Radiologic clinics of North America.

[25]  Kunio Doi,et al.  Integrating PET and CT information to improve diagnostic accuracy for lung nodules: A semiautomatic computer-aided method. , 2006, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[26]  R. Yung Tissue diagnosis of suspected lung cancer: selecting between bronchoscopy, transthoracic needle aspiration, and resectional biopsy. , 2003, Respiratory care clinics of North America.

[27]  H. Ohmatsu,et al.  Detection failures in spiral CT screening for lung cancer: analysis of CT findings. , 1999, Radiology.

[28]  M. Reiser,et al.  Material differentiation by dual energy CT: initial experience , 2007, European Radiology.

[29]  K. Bae,et al.  Pulmonary nodules: automated detection on CT images with morphologic matching algorithm--preliminary results. , 2005, Radiology.

[30]  G. Watanabe,et al.  Pathologic and biological assessment of lung tumors showing ground-glass opacity. , 2006, The Annals of thoracic surgery.

[31]  R. Coleman,et al.  Focal pulmonary abnormalities: evaluation with F-18 fluorodeoxyglucose PET scanning. , 1993, Radiology.

[32]  A. Wilson,et al.  Ultrasound features of folded lung. , 1996, Clinical radiology.

[33]  Noriyuki Tomiyama,et al.  Temporal subtraction for detection of solitary pulmonary nodules on chest radiographs: evaluation of a commercially available computer-aided diagnosis system. , 2002, Radiology.

[34]  Anthony P. Reeves,et al.  Three-dimensional segmentation and growth-rate estimation of small pulmonary nodules in helical CT images , 2003, IEEE Transactions on Medical Imaging.

[35]  Frank Fischbach,et al.  Clinical results of CsI-detector-based dual-exposure dual energy in chest radiography , 2003, European Radiology.

[36]  J. Austin,et al.  Glossary of terms for CT of the lungs: recommendations of the Nomenclature Committee of the Fleischner Society. , 1996, Radiology.

[37]  Margrit Betke,et al.  Landmark detection in the chest and registration of lung surfaces with an application to nodule registration , 2003, Medical Image Anal..

[38]  Kunio Doi,et al.  Computer-aided diagnosis in thoracic CT. , 2005, Seminars in ultrasound, CT, and MR.

[39]  K. Awai,et al.  Pulmonary nodules at chest CT: effect of computer-aided diagnosis on radiologists' detection performance. , 2004, Radiology.

[40]  Margrit Betke,et al.  Chest CT: automated nodule detection and assessment of change over time--preliminary experience. , 2001, Radiology.

[41]  K. Yasumoto,et al.  Peripheral lung adenocarcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival. , 2001, Radiology.

[42]  C. Yi,et al.  Solitary pulmonary nodules: dynamic enhanced multi-detector row CT study and comparison with vascular endothelial growth factor and microvessel density. , 2004, Radiology.

[43]  K. Doi,et al.  Computer-aided diagnosis of pulmonary nodules: results of a large-scale observer test. , 1999, Radiology.

[44]  L. Schwartz,et al.  Evaluation of tumor measurements in oncology: use of film-based and electronic techniques. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[45]  Binsheng Zhao,et al.  Small pulmonary nodules: volumetrically determined growth rates based on CT evaluation. , 2000, Radiology.

[46]  E. Krupinski,et al.  Searching for lung nodules. Visual dwell indicates locations of false-positive and false-negative decisions. , 1989, Investigative radiology.

[47]  Kunio Doi,et al.  Computer-aided diagnosis for improved detection of lung nodules by use of posterior-anterior and lateral chest radiographs. , 2007, Academic radiology.

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

[49]  K S Berbaum,et al.  Role of faulty visual search in the satisfaction of search effect in chest radiography. , 1998, Academic radiology.

[50]  K. Marten,et al.  Computer-aided detection of pulmonary nodules: influence of nodule characteristics on detection performance. , 2005, Clinical radiology.

[51]  J. Wild,et al.  Lung magnetic resonance imaging – an update , 2008 .

[52]  Hiroto Hatabu,et al.  Solitary pulmonary nodules: potential role of dynamic MR imaging in management initial experience. , 2002, Radiology.

[53]  Bram van Ginneken,et al.  A computer-aided diagnosis system for detection of lung nodules in chest radiographs with an evaluation on a public database , 2006, Medical Image Anal..

[54]  L. Ketai,et al.  Small nodules detected on chest radiography: does size predict calcification? , 2000, Chest.

[55]  Frank Fischbach,et al.  Value of axial and coronal maximum intensity projection (MIP) images in the detection of pulmonary nodules by multislice spiral CT: comparison with axial 1-mm and 5-mm slices , 2006, European Radiology.

[56]  Fritz Schick,et al.  Solitary pulmonary nodules: association between signal characteristics in dynamic contrast enhanced MRI and tumor angiogenesis. , 2006, Lung cancer.

[57]  J. Austin,et al.  Primary carcinoma of the lung overlooked at CT: analysis of findings in 14 patients. , 1996, Radiology.

[58]  Takeshi Nakaura,et al.  Pulmonary nodules: estimation of malignancy at thin-section helical CT--effect of computer-aided diagnosis on performance of radiologists. , 2006, Radiology.

[59]  H L Kundel,et al.  Mechanism of satisfaction of search: eye position recordings in the reading of chest radiographs. , 1995, Radiology.

[60]  Margrit Betke,et al.  Small pulmonary nodules: volume measurement at chest CT--phantom study. , 2003, Radiology.

[61]  Lubomir M. Hadjiiski,et al.  Pulmonary nodule registration in serial CT scans based on rib anatomy and nodule template matching. , 2007, Medical physics.

[62]  K. Bae,et al.  Automated detection of pulmonary nodules on CT images: effect of section thickness and reconstruction interval--initial results. , 2005, Radiology.

[63]  M. Revel,et al.  Are two-dimensional CT measurements of small noncalcified pulmonary nodules reliable? , 2004, Radiology.

[64]  L. Broemeling,et al.  Interobserver and intraobserver variability in measurement of non-small-cell carcinoma lung lesions: implications for assessment of tumor response. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[65]  Marco Das,et al.  Small pulmonary nodules: effect of two computer-aided detection systems on radiologist performance. , 2006, Radiology.

[66]  L. S. Broderick,et al.  Dual-energy subtraction chest radiography: what to look for beyond calcified nodules. , 2006, Radiographics : a review publication of the Radiological Society of North America, Inc.

[67]  V. P. Collins,et al.  Observations on growth rates of human tumors. , 1956, The American journal of roentgenology, radium therapy, and nuclear medicine.

[68]  J. Austin,et al.  Missed non-small cell lung cancer: radiographic findings of potentially resectable lesions evident only in retrospect. , 2003, Radiology.

[69]  J. Austin,et al.  Missed bronchogenic carcinoma: radiographic findings in 27 patients with a potentially resectable lesion evident in retrospect. , 1992, Radiology.

[70]  Yoshifumi Yasuhara,et al.  Clinical evaluation of pulmonary nodules with dual-exposure dual-energy subtraction chest radiography. , 2005, Radiation medicine.

[71]  Kunio Doi,et al.  Computer-aided diagnosis in chest radiology. , 2004, Seminars in ultrasound, CT, and MR.

[72]  Kenya Murase,et al.  Detectability of lung nodules using flat panel detector with dual energy subtraction by two shot method: evaluation by ROC method. , 2007, European journal of radiology.

[73]  E. Patz 1999 plenary session: Friday imaging symposium : evaluation of focal pulmonary abnormalities with FDG PET. , 2000, Radiographics : a review publication of the Radiological Society of North America, Inc.

[74]  S. Sone,et al.  CT findings and progression of small peripheral lung neoplasms having a replacement growth pattern. , 2003, AJR. American journal of roentgenology.

[75]  O. Miettinen,et al.  CT screening for lung cancer: frequency and significance of part-solid and nonsolid nodules. , 2002, AJR. American journal of roentgenology.

[76]  L. Schwartz,et al.  Pulmonary nodules resected at video-assisted thoracoscopic surgery: etiology in 426 patients. , 1999, Radiology.

[77]  Naofumi Hayabuchi,et al.  Dynamic MRI of solitary pulmonary nodules: comparison of enhancement patterns of malignant and benign small peripheral lung lesions. , 2007, AJR. American journal of roentgenology.

[78]  Michael K Gould,et al.  Evidence-Based Clinical Practice Guidelines Nodules : When Is It Lung Cancer ? : ACCP Evaluation of Patients With Pulmonary , 2007 .

[79]  F. Schick,et al.  Solitary pulmonary nodules: dynamic contrast-enhanced MR imaging--perfusion differences in malignant and benign lesions. , 2004, Radiology.

[80]  Ehsan Samei,et al.  Subtle lung nodules: influence of local anatomic variations on detection. , 2003, Radiology.

[81]  Mathias Prokop,et al.  Pulmonary nodules: sensitivity of maximum intensity projection versus that of volume rendering of 3D multidetector CT data. , 2007, Radiology.

[82]  Z. Gao,et al.  Quantitative Diagnosis of Fatty Liver With Dual-Energy CT , 2003 .

[83]  M. Tillich,et al.  Detection of pulmonary nodules with helical CT: comparison of cine and film-based viewing. , 1997, AJR. American journal of roentgenology.

[84]  S. Sone,et al.  Atypical adenomatous hyperplasia of the lung: correlation between high-resolution CT findings and histopathologic features , 2001, European Radiology.

[85]  E. Moore,et al.  Technical aspects of needle aspiration lung biopsy: a personal perspective. , 1998, Radiology.

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

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

[88]  G. Chatellier,et al.  Pulmonary nodules: preliminary experience with three-dimensional evaluation. , 2004, Radiology.

[89]  Kunio Doi,et al.  Effect of temporal subtraction technique on interpretation time and diagnostic accuracy of chest radiography. , 2006, AJR. American journal of roentgenology.

[90]  V. P. Collins,et al.  Differentiation of benign and malignant pulmonary nodules by growth rate. , 1962, Radiology.

[91]  Arunabh Talwar,et al.  False-Positive PET Scan in a Patient With Lipoid Pneumonia Simulating Lung Cancer , 2004, Clinical nuclear medicine.

[92]  Frank Fischbach,et al.  Dual-energy chest radiography with a flat-panel digital detector: revealing calcified chest abnormalities. , 2003, AJR. American journal of roentgenology.

[93]  Kenji Suzuki,et al.  Radiologic classification of small adenocarcinoma of the lung: radiologic-pathologic correlation and its prognostic impact. , 2006, The Annals of thoracic surgery.

[94]  Mortensen,et al.  4. Preliminary Findings of a Prospective Study of FDG-PET in Patients with Possible Lung Cancer. , 2000, Clinical positron imaging : official journal of the Institute for Clinical P.E.T.

[95]  M. McNitt-Gray,et al.  Lung micronodules: automated method for detection at thin-section CT--initial experience. , 2003, Radiology.

[96]  K. Doi,et al.  Radiologists' performance for differentiating benign from malignant lung nodules on high-resolution CT using computer-estimated likelihood of malignancy. , 2004, AJR. American journal of roentgenology.

[97]  D. Sautereau,et al.  Dual-energy CT in the diagnosis and quantification of fatty liver: limited clinical value in comparison to ultrasound scan and single-energy CT, with special reference to iron overload. , 1998, Journal of hepatology.

[98]  M. Noguchi,et al.  The development and progression of adenocarcinoma of the lung. , 1995, Cancer treatment and research.

[99]  W. Heindel,et al.  Volumetric measurements of pulmonary nodules at multi-row detector CT: in vivo reproducibility , 2003, European Radiology.

[100]  P. Cooperberg,et al.  Computer-aided detection in screening CT for pulmonary nodules. , 2006, AJR. American journal of roentgenology.

[101]  S. Swensen,et al.  O-127 Evaluation of nodules detected by screening for lung cancer with low dose spiral computed tomography , 2003 .

[102]  J. Ko,et al.  Multidetector CT of solitary pulmonary nodules. , 2010, Radiologic clinics of North America.

[103]  O. Hoekstra,et al.  The performance of( 18)F-fluorodeoxyglucose positron emission tomography in small solitary pulmonary nodules. , 2004, European journal of nuclear medicine and molecular imaging.

[104]  K. J. Lee,et al.  CT halo sign: the spectrum of pulmonary diseases. , 2005, The British journal of radiology.

[105]  S J Swensen,et al.  Solitary pulmonary nodule: CT evaluation of enhancement with iodinated contrast material--a preliminary report. , 1992, Radiology.

[106]  J. Minna,et al.  Molecular pathogenesis of lung cancer. , 1994, Annual review of physiology.

[107]  O S Miettinen,et al.  Early Lung Cancer Action Project , 2001, Cancer.

[108]  Koichi Yamazaki,et al.  CT-guided transbronchial biopsy using an ultrathin bronchoscope with virtual bronchoscopic navigation. , 2004, Chest.

[109]  H Nakata,et al.  Evolution of peripheral lung adenocarcinomas: CT findings correlated with histology and tumor doubling time. , 2000, AJR. American journal of roentgenology.

[110]  M. Mahoney,et al.  CT demonstration of calcification in carcinoma of the lung. , 1990, AJR. American journal of roentgenology.

[111]  O. Miettinen,et al.  Early Lung Cancer Action Project: overall design and findings from baseline screening , 1999, The Lancet.

[112]  J. Debatin,et al.  HASTE MRI versus chest radiography in the detection of pulmonary nodules: comparison with MDCT. , 2004, AJR. American journal of roentgenology.

[113]  N. Müller,et al.  Lung nodule enhancement at CT: multicenter study. , 2000, Radiology.

[114]  Anthony J. Sherbondy,et al.  Pulmonary nodules on multi-detector row CT scans: performance comparison of radiologists and computer-aided detection. , 2005, Radiology.

[115]  T. Naruke,et al.  A clinicopathological study of resected pulmonary nodules with focal pure ground-glass opacity. , 2006, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

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

[117]  S. Armato,et al.  Lung cancer: performance of automated lung nodule detection applied to cancers missed in a CT screening program. , 2002, Radiology.

[118]  A. Ernst,et al.  Real-time electromagnetic navigation bronchoscopy to peripheral lung lesions using overlaid CT images: the first human study. , 2006, Chest.

[119]  Simina C. Fluture,et al.  Small pulmonary nodules: reproducibility of three-dimensional volumetric measurement and estimation of time to follow-up CT. , 2004, Radiology.

[120]  Margrit Betke,et al.  Automatic 3D Registration of Lung Surfaces in Computed Tomography Scans , 2001, MICCAI.

[121]  S. Sone,et al.  Prognostic significance of high-resolution CT findings in small peripheral adenocarcinoma of the lung: a retrospective study on 64 patients. , 2002, Lung cancer.

[122]  C. Ganter,et al.  MRI of the lung: Value of different turbo spin‐echo, single‐shot turbo spin‐echo, and 3D gradient‐echo pulse sequences for the detection of pulmonary metastases , 2007, Journal of magnetic resonance imaging : JMRI.

[123]  J. Debatin,et al.  Detection of pulmonary nodules using a 2D HASTE MR sequence: comparison with MDCT. , 2005, AJR. American journal of roentgenology.

[124]  J. Gurney,et al.  Missed lung cancer at CT: imaging findings in nine patients. , 1996, Radiology.

[125]  Jeffrey L Duerk,et al.  Volumetric assessment of pulmonary nodules with ECG-gated MDCT. , 2004, AJR. American journal of roentgenology.

[126]  S. Swensen,et al.  The probability of malignancy in solitary pulmonary nodules. Application to small radiologically indeterminate nodules. , 1997, Archives of internal medicine.

[127]  M. Chung,et al.  Solitary Pulmonary Nodule : Characterization with Combined Wash-in and Washout Features at Dynamic Multi – Detector Row CT 1 , 2005 .

[128]  T. Gildea,et al.  Electromagnetic navigation diagnostic bronchoscopy: a prospective study. , 2006, American journal of respiratory and critical care medicine.

[129]  O. Miettinen,et al.  CT screening for lung cancer: suspiciousness of nodules according to size on baseline scans. , 2004, Radiology.

[130]  Rajiv Gupta,et al.  Small pulmonary nodules: evaluation with repeat CT--preliminary experience. , 1999, Radiology.

[131]  Takashi Ohtsuka,et al.  Differentiating between atypical adenomatous hyperplasia and bronchioloalveolar carcinoma using the computed tomography number histogram. , 2003, The Annals of thoracic surgery.

[132]  P. Babyn,et al.  CT characteristics of lung nodules present at diagnosis of extrapulmonary malignancy in children. , 2010, AJR. American journal of roentgenology.

[133]  K. Eguchi,et al.  Prospective study of thoracoscopic limited resection for ground-glass opacity selected by computed tomography. , 2003, The Annals of thoracic surgery.

[134]  Berkman Sahiner,et al.  Lung nodule detection on thoracic computed tomography images: preliminary evaluation of a computer-aided diagnosis system. , 2002, Medical physics.

[135]  J. Goo,et al.  CT Findings of Atypical Adenomatous Hyperplasia in the Lung , 2006, Korean journal of radiology.