Morphology of the Microvascular Bed in Primary Human Carcinomas of Lung

Zieliński, Krzysztof; Kulig, Andrzej

doi:10.1016/s0344-0338(84)80106-5

Cited by 21 publications

(8 citation statements)

References 13 publications

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“…[2][3][4][5][6][7][8] It has been repeatedly shown that there are distinct differences in the vascularity and vasculature of benign and malignant nodules. [13][14][15][16] Contrast-enhanced dynamic CT may demonstrate these differences by evaluating blood flow patterns and microvessel density. [2][3][4][6][7][8]17 Since Swensen et al 2 reported that malignant nodules increase by 20 HU or greater, many investigators have sought to find the ideal cutoff value for differentiating benignity from malignancy.…”

Section: Differentiation Between Benign and Malignant Lesionsmentioning

confidence: 99%

Dual-energy Computed Tomography Characterization of Solitary Pulmonary Nodules

Chae

Song

Krauß

et al. 2010

Journal of Thoracic Imaging

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For the assessment of solitary pulmonary nodules (SPNs), a chest computed tomography (CT) is often performed as a combination of a nonenhanced and an enhanced scan. A nonenhanced scan is used for the detection of calcification in the SPN or lymph node, as the presence of calcification is one of the important determinants of benignity. An enhanced scan is informative in providing the degree and pattern of enhancement. In particular, the degree of enhancement of an SPN after iodine injection has been shown to be helpful in distinguishing malignant from benign nodules. Recently introduced dual-energy applications of dual-source CT simultaneously provide a virtual nonenhanced and an iodine-enhanced image from a single scan, after the administration of iodine contrast material. Therefore, a single enhanced dual-energy CT scan allows both measurement of the degree of enhancement and detection of calcifications. It may reduce radiation exposure to patients by avoiding baseline nonenhanced scans and may also reduce measurement error due to different regions of interest during the subtraction of a nonenhanced image from an enhanced image. This technique may have applications in contrast-enhanced dynamic CT and perfusion CT for the differentiation between benign and malignant lesions and the assessment of tumor angiogenesis. In this review article, we sought to address the usefulness of dual-energy CT for the assessment of SPN. In addition, we briefly review the physical principles of dual-energy CT and discuss potential future applications in patients with lung nodules.

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Section: Differentiation Between Benign and Malignant Lesionsmentioning

confidence: 99%

Dual-energy Computed Tomography Characterization of Solitary Pulmonary Nodules

Chae

Song

Krauß

et al. 2010

Journal of Thoracic Imaging

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“…Diagnostic evaluation of SPN using conventional CT consists of two major parts: morphologic features (such as size, margins, contour, internal characteristics [ 7 ]) and degree of enhancement. Measuring the enhancement degree of SPN which is directly related to the vascularity and distribution of the intravascular and extracellular spaces, has proven to be helpful in distinguishing malignant nodules from benign ones in dynamic contrast-enhanced CT [ 8 – 11 ], due to the distinct differences in the vascularity and vasculature of benign and malignant nodules [ 12 – 14 ]. The disorder and variety of the arrangement of vessels along with large intravascular and interstitial spaces in lung cancer would contribute to rich and rapid peak enhancement and retention of contrast medium [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…Measuring the enhancement degree of SPN which is directly related to the vascularity and distribution of the intravascular and extracellular spaces, has proven to be helpful in distinguishing malignant nodules from benign ones in dynamic contrast-enhanced CT [ 8 – 11 ], due to the distinct differences in the vascularity and vasculature of benign and malignant nodules [ 12 – 14 ]. The disorder and variety of the arrangement of vessels along with large intravascular and interstitial spaces in lung cancer would contribute to rich and rapid peak enhancement and retention of contrast medium [ 11 , 12 ]. Most of the inflammatory pulmonary lesions also enhance strongly because of the vascular supply from the bronchial arteries [ 11 ], and washout might be seen after peak enhancement was reached, since contrast medium would flow through relatively straight vessels with a normal configuration and be accelerated by active lymphatic flow [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Can Spectral CT Imaging Improve the Differentiation between Malignant and Benign Solitary Pulmonary Nodules?

et al. 2016

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PurposeTo quantitatively assess the value of dual-energy CT (DECT) in differentiating malignancy and benignity of solitary pulmonary nodules.Materials and MethodsSixty-three patients with solitary pulmonary nodules detected by CT plain scan underwent contrast enhanced CT scans in arterial phase (AP) and venous phase (VP) with spectral imaging mode for tumor type differentiation. The Gemstone Spectral Imaging (GSI) viewer was used for image display and data analysis. Region of interest was placed on the relatively homogeneous area of the nodule to measure iodine concentration (IC) on iodine-based material decomposition images and CT numbers on monochromatic image sets to generate spectral HU curve. Normalized IC (NIC), slope of the spectral HU curve (λHU) and net CT number enhancement on 70keV images were calculated. The two-sample t-test was used to compare quantitative parameters. Receiver operating characteristic curves were generated to calculate sensitivity and specificity.ResultsThere were 63 nodules, with 37 malignant nodules (59%) and 26 benign nodules (41%). NIC, λHU and net CT number enhancement on 70keV images for malignant nodules were all greater than those of benign nodules. NIC and λHU had intermediate to high performances to differentiate malignant nodules from benign ones with the areas under curve of 0.89 and 0.86 respectively in AP, 0.96 and 0.89 respectively in VP. Using 0.30 as a threshold value for NIC in VP, one could obtain sensitivity of 93.8% and specificity of 85.7% for differentiating malignant from benign solitary pulmonary nodules. These values were statistically higher than the corresponding values of 74.2% and 53.8% obtained with the conventional CT number enhancement.ConclusionsDECT imaging with GSI mode provides more promising value in quantitative way for distinguishing malignant nodules from benign ones than CT enhancement numbers.

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“…It has been suggested that blood flow in malignant pulmonary nodules is qualitatively and quantitatively different than flow in benign nodules is. 16,[38][39][40][41] The degree of enhancement is directly related to the likelihood of malignancy and to the vascularity of the nodule. 38,42 In a recent study of 107 patients, thin collimation CT was performed before and after intravenous contrast administration.…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

Imaging of the Solitary Pulmonary Nodule

Erasmus

Patz

1998

Semin Respir Crit Care Med

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The solitary pulmonary nodule continues to be a common finding on radiographic studies. In order to determine etiology, diagnostic evaluation begins with comparison with old films in an attempt to demonstrate at least 2-year stability. If this cannot be established, then additional studies including computed tomography or positron emission tomography imaging are often performed to distinguish a benign lesion from a malignant one. If a specific benign diagnosis cannot made, management options for radiographically indeterminate nodules include percutaneous biopsy, surgical resection, or observation. Treatment decisions are often complex and depend on a number of factors, including radiographic appearance, presenting symptoms, clinical status, and past medical history.

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Morphology of the Microvascular Bed in Primary Human Carcinomas of Lung

Cited by 21 publications

References 13 publications

Dual-energy Computed Tomography Characterization of Solitary Pulmonary Nodules

Dual-energy Computed Tomography Characterization of Solitary Pulmonary Nodules

Can Spectral CT Imaging Improve the Differentiation between Malignant and Benign Solitary Pulmonary Nodules?

Imaging of the Solitary Pulmonary Nodule

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