Are Two-dimensional CT Measurements of Small Noncalcified Pulmonary Nodules Reliable?

Revel, Marie‐Pierre; Bissery, Alvine; Bienvenu, Marie; Aycard, L.; Lefort, C.; Frija, G.

doi:10.1148/radiol.2312030167

Cited by 320 publications

(201 citation statements)

References 16 publications

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“…Volume for all nodules was calculated based on nodule diameter (V = 1/6 * * [ab 2 ], with a the longest and b the perpendicular diameter). Especially in sub-solid nodules, but also in solid nodules, diameter measurements are less accurate than volume measurements [7,8]. Furthermore, the study used relatively thick slice-thickness (3.75-5 mm) and large reconstruction intervals (5 mm) that may have contributed to even more imprecise diameter measurements, especially for sub-centimeter nodules.…”

Section: Discussionmentioning

confidence: 98%

“…Furthermore, lung cancer growth patterns were only visually evaluated and not quantified. In the Dutch-Belgian randomized lung cancer screening trial (Dutch acronym: NELSON), nodule volumes were generated semi-automatically by software; a far more accurate way to determine nodule size [7,8]. In addition, for subsequent screening rounds VDTs were determined based on nodule volume [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Quantification of growth patterns of screen-detected lung cancers: The NELSON study

et al. 2017

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a b s t r a c tObjectives: Although exponential growth is assumed for lung cancer, this has never been quantified in vivo. Aim of this study was to evaluate and quantify growth patterns of lung cancers detected in the Dutch-Belgian low-dose computed tomography (CT) lung cancer screening trial (NELSON), in order to elucidate the development and progression of early lung cancer. Materials and methods: Solid lung nodules found at ≥3 CT examinations before lung cancer diagnosis were included. Lung cancer volume (V) growth curves were fitted with a single exponential, expressed as V = V 1 exp(t/ ), with t time from baseline (days), V 1 estimated baseline volume (mm 3 ), and estimated time constant. The R 2 coefficient of determination was used to evaluate goodness of fit. Overall volumedoubling time for the individual lung cancer is given by * log(2). Results: Forty-seven lung cancers in 46 participants were included. Forty participants were male (87.0%); mean age was 61.7 years (standard deviation, 6.2 years). Median nodule size at baseline was 99.5 mm 3 (IQR: 46.8-261.8 mm 3 ). Nodules were followed for a median of 770 days (inter-quartile range: 383-1102 days) before lung cancer diagnosis. One cancer (2.1%) was diagnosed after six CT examinations, six cancers (12.8%) were diagnosed after five CTs, 14 (29.8%) after four CTs, and 26 cancers (55.3%) after three CTs. Lung cancer growth could be described by an exponential function with excellent goodness of fit (R 2 0.98). Median overall volume-doubling time was 348 days (inter-quartile range: 222-492 days). Conclusion: This study based on CT lung cancer screening provides in vivo evidence that growth of cancerous small-to-intermediate sized lung nodules detected at low-dose CT lung cancer screening can be described by an exponential function such as volume-doubling time.© 2017 Elsevier B.V. All rights reserved.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Quantification of growth patterns of screen-detected lung cancers: The NELSON study

et al. 2017

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“…For the evaluation of solid pulmonary nodules three-dimensional volumetric assessment has been shown to be more accurate than two-dimensional measurements [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Detection and quantification of the solid component in pulmonary subsolid nodules by semiautomatic segmentation

et al. 2014

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Objective To determine whether semiautomatic volumetric software can differentiate part-solid from nonsolid pulmonary nodules and aid quantification of the solid component. Methods As per reference standard, 115 nodules were differentiated into nonsolid and part-solid by two radiologists; disagreements were adjudicated by a third radiologist. The diameters of solid components were measured manually. Semiautomatic volumetric measurements were used to identify and quantify a possible solid component, using different Hounsfield unit (HU) thresholds. The measurements were compared with the reference standard and manual measurements.

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“…Other disadvantages of X-ray analysis include inability to identify small-area ossifications and to accurately locate the ossification. When evaluating a pulmonary nodule, 3D measurement is more reliable in determining changes in growth [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…Recent technical improvements in computed tomography (CT)-based three-dimensional (3D) imaging analysis have made accurate 3D measurement of OPLL possible [5,11]. Previous studies on lung cancer growth found that evaluation of the growth of lung cancer using a 3D measurement method was more reliable than using a 2D method [12][13][14][15]. The present study was designed to evaluate the accuracy of a novel CT-based method of 3D analysis we had previously devised, to measure changes in the volume of OPLL.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional evaluation of volume change in ossification of the posterior longitudinal ligament of the cervical spine using computed tomography

et al. 2013

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Background Two-dimensional imaging is not adequate for evaluating ossification of the posterior longitudinal ligament (OPLL). This study was designed to evaluate the accuracy of a novel computed tomography (CT)-based three-dimensional (3D) analysis method that we had devised to measure volume changes in OPLL. Subjects and methods Twenty OPLL patients (12 male and 8 female; mean age 63.6 years) who were being followed conservatively were examined twice with an interval of at least 1 year between the two scans. The mean interval was 22 (range 12-45) months. A 3D model was created with DICOM data from CT images, using the MIMICS Ò software to calculate the volume. The mean ossification volume was determined from two measurements. Since ossification size varies widely, evaluation of change in volume is generally affected by the original size. Therefore, the change in ossification volume between the first and second CT examinations was calculated as the annual rate of progression. Results The type of OPLL was classified as continuous in 3 patients, segmented in 3, and mixed in 14. The mean ossification volume was 1,831.68 mm 3 at the first examination and 1,928.31 mm 3 at the second, showing a significant mean increase in ossification volume. The mean annual rate of lesion increase was 3.33 % (range 0.08-7.79 %). Conclusion The 3D method used allowed detailed OPLL classification and quantification of change in the ossified volume. Thus, this method appears to be very useful for quantitative evaluation of OPLL with only minimal measurement error.

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Are Two-dimensional CT Measurements of Small Noncalcified Pulmonary Nodules Reliable?

Abstract: Two-dimensional CT measurements are not reliable in the evaluation of small noncalcified pulmonary nodules.

Cited by 320 publications

References 16 publications

Quantification of growth patterns of screen-detected lung cancers: The NELSON study

Quantification of growth patterns of screen-detected lung cancers: The NELSON study

Detection and quantification of the solid component in pulmonary subsolid nodules by semiautomatic segmentation

Three-dimensional evaluation of volume change in ossification of the posterior longitudinal ligament of the cervical spine using computed tomography

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