Compare Display Schemes for Lung Nodule CT Screening

Abstract

This study investigated the relative efficiencies of a stereographic display and two monoscopic display schemes for detecting lung nodules in chest computed tomography (CT). The ultimate goal was to determine whether stereoscopic display provides advantages for visualization and interpretation of three-dimensional (3D) medical image datasets. A retrospective study that compared lung nodule detection performances achieved using three different schemes for displaying 3D CT data was conducted. The display modes included slice-byslice, orthogonal maximum intensity projection (MIP), and stereoscopic display. One hundred lung-cancer screening CT examinations containing 647 nodules were interpreted by eight radiologists, in each of the display modes. Reading times and displayed slab thickness versus time were recorded, as well as the probability, location, and size for each detected nodule. Nodule detection performance was analyzed using the receiver operating characteristic method. The stereo display mode provided higher detection performance with a shorter interpretation time, as compared to the other display modes tested in the study, although the difference was not statistically significant. The analysis also showed that there was no difference in the patterns of displayed slab thickness versus time between the stereo and MIP display modes. Most radiologists preferred reading the 3D data at a slab thickness that corresponded to five CT slices. Our results indicate that stereo display has the potential to improve radiologists' performance for detecting lung nodules in CT datasets. The experience gained in conducting the study also strongly suggests that further benefits can be achieved through providing readers with additional functionality.

Comparison of Transverse Computed Tomographic Excretory Urography Images and Maximum Intensity Projection Images for Diagnosing Ectopic Ureters in Dogs

“…The ability to view only the brightest pixels helps to define smaller structures. This post processing technique has been used to identify vascular structures, pulmonary nodules, and ureteral stones in people and dogs, and is reported to improve abnormality detection rates as compared to axial source images alone . In addition, MIP images have been shown to provide greater reader confidence in detection of pulmonary nodules in a canine model .…”

Stereoscopic Integrated Imaging Goggles for Multimodal Intraoperative Image Guidance

“…Previous research into 3D medical imaging has found applications in ophthalmology, mammography, oncology, orthopedic studies, and vascular mapping among others [ 6 , 30 – 31 ]. Various modalities have been implemented for 3D stereoscopic imaging including X-ray, CT and visual imaging [ 32 – 36 ]. In detecting breast cancer lesions, Getty et al found a 44% decrease in false positives when utilizing stereoscopic mammography [ 37 ].…”

Lung Nodule and Cancer Detection in Computed Tomography Screening

“…The use of stereoscopic display to view TS-MIPs has been shown to improve nodule detection and shorten interpretation time when compared to standard viewing (8), and the use of thin-slab volume rendering has been shown to significantly improve the detection of lung nodules relative to TS-MIP for nodules <11 mm in diameter (49). …”

“…These guidelines are consistent with the CT techniques used in both the National Lung Screening Trial (NLST) and the NELSON trials (6, 7). When viewing transverse sections, image size, reader distance from the image, paging rate, and the use of stereoscopic display have been shown to influence lung nodule detection (8–10). This review focuses on issues concerning the assessment of reader performance for the identification of lung nodules, the current understanding of radiologist’s performance, and steps that have been investigated to improve radiologist performance in the identification of lung nodules in general and lung cancer in particular.…”