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Three-Dimensional Detection of Pulmonary Nodules in Chest CT Images  [cached]
Aliaa A. A. Youssif,Shereen A. Hussein,Ahmed S. Ibrahim
Computer and Information Science , 2011, DOI: 10.5539/cis.v4n5p2
Abstract: Small pulmonary nodules are radiologic findings that represent an important challenge in diagnosis systems. While these nodules are the major indicator for lung cancer and metastasis, their properties like size and location play an important role in classifying the benign one from the malignant. Estimating the growth rate of the nodule size states the degree of malignancy. This paper presents a computer-aided diagnosis (CAD) system to detect small-size pulmonary nodules from the chest computed tomography (CT) images through two dimensional (2-D) and three-dimensional (3-D) methods. Also, a computed volumetric growth is a promising way to distinguish malignant from nonmalignant pulmonary nodules. It was applied to lung nodules (2 to 7 mm in diameter) and achieved sensitivity 94.6% with an average; it is expected to aid radiologists in the detection of small nodules on thin-section multi–detector row CT images.
Three Dimensional Volumetric Analysis of Solid Pulmonary Nodules on Chest CT: ?Cancer Risk Assessment  [PDF]
Mengqi LI, Rongcheng HAN, Wenjing SONG, Xinyue WANG, Fangfang GUO, Datong SU, Tielian YU, Ying WANG
- , 2016, DOI: : 10.3779/j.issn.1009-3419.2016.05.05
Abstract: Background and objective The management of pulmonary nodules relies on cancer risk assessment, in which the only widely accepted criterion is diameter. The development of volumetric computed tomography (CT) and three-dimensional (3D) software enhances the clarity in displaying the nodules’ characteristics. This study evaluated the values of the nodules’ volume and 3D morphological characteristics (edge, shape and location) in cancer risk assessment. Methods The CT data of 200 pulmonary nodules were retrospectively evaluated using 3D volumetric software. The malignancy or benignity of all the nodules was confirmed by pathology, histology or follow up (>2 years). Logistic regression analysis was performed to calculate the odds ratios (ORs) of the 3D margin (smooth, lobulated or spiculated/irregular), shape (spherical or non-spherical), location (purely intraparenchymal, juxtavascular or pleural-attached), and nodule volume in cancer risk assessment for total and sub-centimeter nodules. The receiver operating characteristic (ROC) curve was employed to determine the optimal threshold for the nodule volume. Results Out of 200 pulmonary nodules, 78 were malignant, whereas 122 were benign. The Logistic regression analysis showed that the volume (OR=3.3; P<0.001) and the 3D margin (OR=13.4, 9.8; both P=0.001) were independent predictive factors of malignancy, whereas the location and 3D shape exhibited no total predictive value (P>0.05). ROC analysis showed that the optimal threshold for malignancy was 666 mm3. For sub-centimeter nodules, the 3D margin was the only valuable predictive factor of malignancy (OR=60.5, 75.0; P=0.003, 0.007). Conclusion The volume and 3D margin are important factors considered to assess the cancer risk of pulmonary nodules. Volumes larger than 666 mm3 can be determined as high risk for pulmonary nodules; by contrast, nodules with lobulated, spiculated, or irregular margin present a high malignancy probability.
Anomalous Unilateral Single Pulmonary Vein Mimicking Pulmonary Nodules on HRCT of the Lungs and Scimitar Syndrome on the Chest Radiograph: Multidetector CT Findings
Iranian Journal of Radiology , 2009,
Abstract: "nAnomalous unilateral single pulmonary vein (AUSPV) is an extremely rare anomaly of the pulmonary venous system. It is often confused with other pulmonary abnormalities such as hypogenetic lung (scimitar) syndrome, pulmonary varices, pulmonary nodules and arteriovenous malformations. We present multidetector computerized tomography (MDCT) findings in a case of AUSPV mimicking pulmonary nodules on high resolution computed tomography (HRCT) of the lungs and scimitar syndrome on chest radiograph in an asthmatic girl.
Three-dimensional Mass Measurement of Subsolid Pulmonary Nodules on Chest CT: Intra and Inter-observer Variability  [PDF]
Huiting LIU, Ying WANG, Lei FENG, Tielian YU
- , 2015, DOI: : 10.3779/j.issn.1009-3419.2015.05.06
Abstract: Background and objective Subsolid pulmonary nodules tend to exhibit considerably slower growth rates than solid lesions, nevertheless, higher malignancy probability. The diagnosis of indeterminate nodules largely depends on the growth evaluation during follow-up. The growth can manifested as an increase in size or the appearance and/or subsequent increase of solid components. The mass reflect the product of volume and density and can be more sensitive in growth evaluation. However, the repeatability needs a further validation. The purpose of this study is to assess the intra and inter-observer variability of mass measurement for subsolid nodules. Methods 80 subsolid nodules in 44 patients were retrospectively enrolled. Both the volume and mass were measured by two radiologists using blind method independently. Intra-observer and inter-observer variability were analyzed and compared by Bland-Altman method intra-class correlation test and Wilcoxon test. Results Software achieved satisfied segmentation for 92.5% nodules. Of them, 35% underwent manual modification. The 95% limits of agreement for intra-observer variability were -11.5%-10.4% for mass and -8.4%-8.8% for volume. The 95% limits of agreement for inter-observer variability were -17.4%-19.3% for mass and -17.9%-19.4% for volume.The intra-class correlation foefficients between volume and mass measument was 0.95 and 0.93 (both P<0.001) and no significant differences (P=0.78, 0.09) was found for intra- and inter-observer variability. Manual modification of the segmentation caused the worse mass measurement repeatability in spite of the reader satisfaction. Conclusion The repeatability of mass measurement has no significant difference with that of volume measurement and may act as a reliable method in the follow-up of subsolid nodules.
Case report: Pulmonary syphilis mimicking pulmonary hematogenous metastases on chest CT and integrated PET/CT  [cached]
Kim Hyung,Seon Hyun,Shin Hyo,Choi Yoo-Duk
Indian Journal of Radiology and Imaging , 2011,
Abstract: We report a case of syphilis with pulmonary involvement. Chest CT scan and 18 F-fluorodeoxyglucose (FDG) PET/CT showed multiple pulmonary nodules mimicking pulmonary hematogenous metastases. This was confirmed on follow-up images that showed therapeutic response to penicillin.
Effects of Different Reconstruction Parameters on CT Volumetric Measurement of Pulmonary Nodules  [cached]
Rongrong YANG,Tielian YU,Ying WANG,Qing WANG
Chinese Journal of Lung Cancer , 2012, DOI: 10.3779/j.issn.1009-3419.2012.02.02
Abstract: Background and objective It has been proven that volumetric measurements could detect subtle changes in small pulmonary nodules in serial CT scans, and thus may play an important role in the follow-up of indeterminate pulmonary nodules and in differentiating malignant nodules from benign nodules. The current study aims to evaluate the effects of different reconstruction parameters on the volumetric measurements of pulmonary nodules in chest CT scans. Methods Thirty subjects who underwent chest CT scan because of indeterminate pulmonary nodules in General Hospital of Tianjin Medical University from December 2009 to August 2011 were retrospectively analyzed. A total of 52 pulmonary nodules were included, and all CT data were reconstructed using three reconstruction algorithms and three slice thicknesses. The volumetric measurements of the nodules were performed using the advanced lung analysis (ALA) software. The effects of the reconstruction algorithms, slice thicknesses, and nodule diameters on the volumetric measurements were assessed using the multivariate analysis of variance for repeated measures, the correlation analysis, and the Bland-Altman method. Results The reconstruction algorithms (F=13.6, P<0.001) and slice thicknesses (F=4.4, P=0.02) had significant effects on the measured volume of pulmonary nodules. In addition, the coefficients of variation of nine measurements were inversely related with nodule diameter (r=-0.814, P<0.001). The volume measured at the 2.5 mm slice thickness had poor agreement with the volumes measured at 1.25 mm and 0.625 mm, respectively. Moreover, the best agreement was achieved between the slice thicknesses of 1.25 mm and 0.625 mm using the bone algorithm. Conclusion Reconstruction algorithms and slice thicknesses have significant impacts on the volumetric measurements of lung nodules, especially for the small nodules. Therefore, the reconstruction setting in serial CT scans should be consistent in the follow-up of indeterminate pulmonary nodules, more importantly for the small nodules.
Excavated pulmonary nodules: an unusual clinical presentation of lung metastasis in two cases
Wafa Allam, Basma Elkhanoussi, Khaoula Alaoui, Issam Lalya, Hassan Errihani
BMC Medical Imaging , 2010, DOI: 10.1186/1471-2342-10-13
Abstract: The first one is 39-year-old man in whom cholecystectomy made the diagnosis of primary non-Hodgkin's lymphoma of the gallbladder. He presented in chest CT scan excavated nodules that had been biopsied and confirmed the diagnosis of non hodgkin lymphoma. He underwent 8 courses of chemotherapy CHOP 21 with complete remission. The second one is an 21 years old man who presented a right leg osteoblastic osteosarcoma with only excavated pulmonary nodules in extension assessment. He had 3 courses of polychemotherapy API (doxorubicin, platinum, and ifosfamide) with partial response. Unfortunately, he died following a septic shock.Review of the literature shows that excavated pulmonary nodules as metastasis are rare but we should consider this diagnosis every time we are in front of a cancer. Chest computed tomography is the best diagnosis imaging that could make this diagnosis. Differential diagnosis between benign and malignant bullous lesions is important because surgical excision affects survival in some malignancies.Although pulmonary nodules are the most common cancer metastasis, a differential diagnosis of a concurrent primary malignancy should always be considered every time we have excavated lesions, even in patients with known malignant disease. Thorough chest evaluation is important, as multiple primary malignancies may occur concomitantly.Metastatic causes of excavated pulmonary nodules are rare but must be considered in patients with a history of neoplastic disease.Excavated metastatic pulmonary lesions are described, but in a country of epidemic tuberculosis, or in front of smokers, it is necessary to raise differential diagnosis. Sometimes, chest scann permitt to elaborate a definite diagnosis, and sometimes, we must resort to a biopsy. We report here two cases of excavated pulmonary metastasis attendant to primary malignancies.A 39 year old male with no significant past medical history, initially presented with a several month history of intermittent pain lo
A Comparison between Contrast Enhanced Chest CT scan and Biochemical Tests for Differentiation of Transudative from Exudative Pleural Effusions
A. H. Hashemi,S. Naghibi,A. Saffari,M. Ghasemi
Iranian Journal of Radiology , 2008,
Abstract: Background/Objective: Differentiation between transudative and exudative types of pleural effusions is critical in the evaluation and management of pleural effusions .Light's criteria is accepted as a reliable biochemical method for this differentiation. If contrast enhanced chest CT scan has a significant agreement with biochemical tests, it can be considered as a non invasive reliable method for evaluation of pleural effusion. "nPatients and Methods: We evaluated 32 patients who had pleural effusion from June 2005 to June 2006 in 22nd Bahman hospital in Mashhad Both contrast enhanced chest CT scan (with spiral CT scanner, PHILIPS, Mx 8000) and biochemical tests of pleural fluids were done for all patients. Two radiologists separately interpreted the CT images as exudate or transudate based on pleural thickening, nodules or enhancement, and the agreement between two radiologists was evaluated. Biochemical tests of pleural fluids were analyzed based on Light's criteria. Results of CT scans and biochemical tests were compared with Kappa test. "nResults: Both radiologists interpreted CT images as transudate or exudate the same. Sixteen patients were diagnosed as transudate based on CT scan that biochemical tests were consistent with transudate only in eight patients. CT scan diagnosed 16 patients as exudates that biochemical tests were consistent with exudates in all of them. Kappa coefficient was 35% (P value = 0.030) that was interpreted as fair agreement."nConclusion: Chest CT scan is accepted as a good imaging modality in diagnosis of pulmonary and mediastinal Involvement and also presence of pleural effusion. Some studies concluded that chest CT scan can accurately differentiate between exudate and transudate but our study showed that it has a fair agreement with biochemical tests, so we recommend that chest CT scan can't replace biochemical tests to Differentiate exudative from transudative effusions.
The Effects of Computed Tomography with Iterative Reconstruction on Solid Pulmonary Nodule Volume Quantification  [PDF]
Martin J. Willemink, Jaap Borstlap, Richard A. P. Takx, Arnold M. R. Schilham, Tim Leiner, Ricardo P. J. Budde, Pim A. de Jong
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0058053
Abstract: Background The objectives of this study were to evaluate the influence of iterative reconstruction (IR) on pulmonary nodule volumetry with chest computed tomography (CT). Methods Twenty patients (12 women and 8 men, mean age 61.9, range 32–87) underwent evaluation of pulmonary nodules with a 64-slice CT-scanner. Data were reconstructed using filtered back projection (FBP) and IR (Philips Healthcare, iDose4-levels 2, 4 and 6) at similar radiation dose. Volumetric nodule measurements were performed with semi-automatic software on thin slice reconstructions. Only solid pulmonary nodules were measured, no additional selection criteria were used for the nature of nodules. For intra-observer and inter-observer variability, measurements were performed once by one observer and twice by another observer. Algorithms were compared using the concordance correlation-coefficient (pc) and Friedman-test, and post-hoc analysis with the Wilcoxon-signed ranks-test with Bonferroni-correction (significance-level p<0.017). Results Seventy-eight nodules were present including 56 small nodules (volume<200 mm3, diameter<8 mm) and 22 large nodules (volume≥200 mm3, diameter≥8 mm). No significant differences in measured pulmonary nodule volumes between FBP, iDose4-levels 2, 4 and 6 were found in both small nodules and large nodules. FBP and iDose4-levels 2, 4 and 6 were correlated with pc-values of 0.98 or higher for both small and large nodules. Pc-values of intra-observer and inter-observer variability were 0.98 or higher. Conclusions Measurements of solid pulmonary nodule volume measured with standard-FBP were comparable with IR, regardless of the IR-level and no significant differences between measured volumes of both small and large solid nodules were found.
Correlation between the Quantifiable Parameters of Whole Solitary Pulmonary Nodules Perfusion Imaging Derived with Dynamic CT and Nodules Size  [cached]
Shenjiang LI,Xiangsheng XIAO,Shiyuan LIU,Chengzhou LI
Chinese Journal of Lung Cancer , 2009,
Abstract: Background and objective The solitary pulmonary nodules (SPNs) is one of the most common findings on chest radiographs. The blood flow patterns of the biggest single SPNs level has been studied. This assessment may be only a limited sample of the entire region of interest (ROI) and is unrepresentative of the SPNs as a volume. Ideally, SPNs volume perfusion should be measured. The aim of this study is to evaluate the correlation between the quantifiableparameters of SPNs volume perfusion imaging derived with 16-slice spiral CT and 64-slice spiral CT and nodules size. Methods Sixty-five patients with SPNs (diameter≤3 cm; 42 malignant; 12 active inflammatory; 11 benign) underwent multi-location dynamic contrast material-enhanced serial CT scanning mode with stable table were performed; The mean values of valid sections were calculated, as the quantifiable parameters of volume SPNs perfusion imaging derived with16-slice spiral CT and 64-slice spiral CT. The correlation between the quantifiable parameters of SPNs volume perfusion imaging derived with 16-slice spiral CT and 64-slice spiral CT and nodules size were assessed by means of linear regression analysis. Results No significant correlations were found between the nodules size and each of the peak height (PHSPN) (32.15 Hu±14.55 Hu),ratio of peak height of the SPN to that of the aorta (SPN-to-A ratio(13.20±6.18)%, perfusion(PSPN) (29.79±19.12) mLmin-1100 g-1 and mean transit time (12.95±6.53) s (r =0.081, P =0.419; r =0.089, P =0.487; r =0.167, P =0.077; r =0.023, P =0.880). Conclusion No significant correlations were found between the quantifiable parameters of SPNs volume perfusion imaging derived with 16-slice spiral CT and 64-slice spiral CT and nodules size.
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