Application of Gemstone Spectral Computed Tomography Imaging in the Characterization of Solitary Pulmonary Nodules

Lin, Jizheng; Zhang, Liang; Zhang, Chuanyu; Yang, Lei; Lou, He-nan; Wang, Ze-guo

doi:10.1097/rct.0000000000000469

Cited by 24 publications

(20 citation statements)

References 20 publications

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“…Another related condition, benign nodules were principally inflammatory (61.1%). The IC was highest in the active inflammatory group, followed by the malignant group, which has been confirmed by previous studies . The active inflammatory nodule is stimulated by inflammatory agents, which leads to the arteriole and blood capillary becoming more obviously dilated and the vascular permeability increased.…”

Section: Discussionsupporting

confidence: 86%

“…The IC was highest in the active inflammatory group, followed by the malignant group, which has been confirmed by previous studies. 5,18,20 The active inflammatory nodule is stimulated by inflammatory agents, which leads to the arteriole and blood capillary becoming more obviously dilated and the vascular permeability increased. Inflammatory edema tissues compress the drainage vein and increase the hydrostatic pressure of the tissues, and block the blood reflux more obviously in benign than in malignant nodules.…”

Section: Discussionmentioning

confidence: 99%

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Can spectral computed tomography imaging improve the differentiation between malignant and benign pulmonary lesions manifesting as solitary pure ground glass, mixed ground glass, and solid nodules?

Chen

Wei

et al. 2018

Thoracic Cancer

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BackgroundThis study quantitatively assessed the efficacy of spectral computed tomography (CT) imaging parameters for differentiating the malignancy and benignity of solitary pulmonary nodules (SPNs) manifesting as ground glass nodules (GGNs) and solid nodules (SNs).MethodsThe study included 114 patients with SPNs (61 GGNs, and 53 SNs) who underwent CT plain and enhanced scans in the arterial (a) and venous (v) phases using the spectral imaging mode. The spectral CT imaging parameters included: iodine concentrations (IC) of lesions in the arterial (ICLa) and venous (ICLv) phases; normalized IC (NICa/NICv, normalized to the IC in the aorta); the slope of the spectral Hounsfield unit (HU) curve (λHUa/λHUv); and monochromatic CT number (CT40keVa/v, CT70keVa/v) enhancement on 40 and 70 keV images. The two‐sample Mann–Whitney U test was used to compare quantitative parameters between malignant and benign SPNs, SNs, and GGNs.ResultsPathology revealed 75 lung cancer cases, 3 metastatic nodules, 14 benign nodules, and 22 inflammatory nodules. Among the 53 SNs there were 37 malignant and 16 benign nodules. Among the 61 GGNs there were 41 malignant and 20 benign nodules. Overall, the CT40keVa, λHUa, CT40keVv, λHUv, and ICLv of benign SPNs were all greater than those of malignant SPNs (all P < 0.05). For GGNs, CT40keVa/v, CT70keVa/v, λHUa/λHUv, and ICLv of malignant GGNs were all lower than those of benign GGNs.ConclusionSpectral CT imaging is a more promising method for distinguishing malignant from benign nodules, especially in nodules manifesting as GGNs in contrast‐enhanced scanning.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Can spectral computed tomography imaging improve the differentiation between malignant and benign pulmonary lesions manifesting as solitary pure ground glass, mixed ground glass, and solid nodules?

Chen

Wei

et al. 2018

Thoracic Cancer

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“…Third, the majority of selected cases in this study were elderly people with a mean age of 61.5 years, and younger patients should be included in future studies. Fourth, monochromatic CT number was measured only enhanced monochromatic spectral CT imaging at the energy level 40 and 70 keV based on previous studies, ignoring the other keV selection. Fifth, quantifying microvessel densities previously described in a previous study were not included in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Spectral CT imaging has been applied in several of the studies on pulmonary nodules. Most researchers believe that quantitative parameters of spectral CT imaging have certain advantages in the differential diagnosis of benign and malignant pulmonary nodules . There is no study testing the association between the spectral CT imaging parameters and the PD‐L1 expression in lung adenocarcinoma.…”

Section: Introductionmentioning

confidence: 99%

Is there any correlation between spectral CT imaging parameters and PD‐L1 expression of lung adenocarcinoma?

Chen

Shi

et al. 2019

Thoracic Cancer

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Background: The aim of this study was to explore whether spectral computed tomography (CT) imaging parameters are associated with PD-L1 expression of lung adenocarcinoma. Methods: Spectral CT imaging parameters (iodine concentrations [IC] of lesion in arterial phase [ICLa] and venous phase [ICLv], normalized IC [NICa/NICv]normalized to the IC in the aorta, slope of the spectral HU curve [λHUa/λHUv] and enhanced monochromatic CT number [CT40keVa/v, CT70keVa/v] on 40 and 70 keV images) were analyzed in 34 prospectively enrolled lung adenocarcinoma patients with common molecular pathological markers including PD-L1 expression detected with immunohistochemistry. Patients were divided into two groups: positive PD-L1 expression and negative PD-L1 expression groups. Two-sample Mann-Whitney U test was used to test the difference of spectral CT imaging parameters between the two groups. Results: The CT40keVa (127.03 AE 37.92 vs. −54.69 AE 262.04), CT40keVv (124.39 AE 34.71 vs. −45.73 AE 238.97), CT70keVa (49.56 AE 11.76 vs. −136.51 AE 237.08) and CT70keVv (46.13 AE 15.81 vs. −133.10 AE 230.72) parameters in the positive PD-L1 expression group of lung adenocarcinoma were significantly higher than the negative PD-L1 expression group (all P < 0.05). There was no difference detected in IC, NIC and λHU of the arterial and venous phases between both groups (all P > 0.05). Conclusion: CT40keVa, CT40keVv, CT70keVa and CT70keVv were increased in positive PD-L1 expression. These parameters may be used to distinguish the PD-L1 expression state of lung adenocarcinoma.

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“…There are significant differences in the treatment and prognosis between benign and malignant lesions. Therefore, the diagnosis of benign and malignant lesions is of great importance for the disease clinical diagnosis and treatment ( 2 , 3 ). However, differential diagnosis of SPN (benign or malignant) is still an important and difficult task for imaging technology ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Differential diagnostic value of 64‑slice spiral computed tomography in solitary pulmonary nodule

Wang

Zheng

et al. 2018

Exp Ther Med

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The present study aimed to evaluate the diagnostic value of 64-slice spiral multivariate computed tomography (CT) combined with dynamic contrast-enhanced scanning for benign and malignant solitary pulmonary nodules (SPNs). A total of 93 patients with SPN as diagnosed by CT were included. All these patients were subjected to routine and dynamic enhancement CT scanning. After reconstruction, the morphological characteristics following dynamic enhancement were analyzed, and compared for the benign and malignant SPN cases. The incidences of lobulation, spicular sign, pleural indentation and vacuole sign in the malignant SPN group were significantly higher compared with the benign SPN group. During the dynamic enhancement scanning, the CT values at all the time points for the inflammatory and malignant SPN groups were significantly higher than the benign SPN group. No significant differences were observed in the dynamic enhancement CT values at 30, 60, 90 and 120 sec between the inflammatory, and malignant SPN groups. However, in the inflammatory SPN group, the dynamic enhancement CT values at 300 and 540 sec were significantly lower than the malignant SPN group. Notably, the diagnostic accordance rate for the morphological signs combined with dynamic enhancement diagnosis was significantly higher than the morphological signs alone. The 64-slice spiral CT morphological signs combined with dynamic enhancement detection can be more effective for the differential diagnosis of benign and malignant SPN, which may provide potent evidence for the early clinical treatment.

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Application of Gemstone Spectral Computed Tomography Imaging in the Characterization of Solitary Pulmonary Nodules

Abstract: Dual-energy CT gemstone spectral imaging provides a novel method to better characterize pulmonary nodules in double-phase contrast-enhanced scanning.

Cited by 24 publications

References 20 publications

Can spectral computed tomography imaging improve the differentiation between malignant and benign pulmonary lesions manifesting as solitary pure ground glass, mixed ground glass, and solid nodules?

Can spectral computed tomography imaging improve the differentiation between malignant and benign pulmonary lesions manifesting as solitary pure ground glass, mixed ground glass, and solid nodules?

Is there any correlation between spectral CT imaging parameters and PD‐L1 expression of lung adenocarcinoma?

Differential diagnostic value of 64‑slice spiral computed tomography in solitary pulmonary nodule

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