Comparison of flat-panel-detector-based CT and multidetector-row CT in automated volumetry of pulmonary nodules using an anthropomorphic chest phantom

Marten, Katharina; Dullin, Christian; Machann, Wolfram; Js, Schmid; Das, Manas; Haresh, K.P.; Engelke, Christoph

doi:10.1259/bjr/40733553

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…Some in vitro studies have been performed in which artificial nodules were placed at known locations in a thoracic phantom without pulmonary vessels [13][14][15]. Some of these studies were based on older generation CT scanners [13,16].…”

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confidence: 99%

Inter- and intrascanner variability of pulmonary nodule volumetry on low-dose 64-row CT: an anthropomorphic phantom study

Xie¹,

Willemink²,

Zhao³

et al. 2013

BJR

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Objective: To assess inter-and intrascanner variability in volumetry of solid pulmonary nodules in an anthropomorphic thoracic phantom using low-dose CT. Methods: Five spherical solid artificial nodules [diameters 3, 5, 8, 10 and 12 mm; CT density 1100 Hounsfield units (HU)] were randomly placed inside an anthropomorphic thoracic phantom in different combinations. The phantom was examined on two 64-row multidetector CT (64-MDCT) systems (CT-A and CT-B) from different vendors with a low-dose protocol. Each CT examination was performed three times. The CT examinations were evaluated twice by independent blinded observers. Nodule volume was semi-automatically measured by dedicated software. Interscanner variability was evaluated by Bland-Altman analysis and expressed as 95% confidence interval (CI) of relative differences. Intrascanner variability was expressed as 95% CI of relative variation from the mean.Results: No significant difference in CT-derived volume was found between CT-A and CT-B, except for the 3-mm nodules (p,0.05). The 95% CI of interscanner variability was within 641.6%, 618.2% and 64.9% for 3, 5 and $8 mm nodules, respectively. The 95% CI of intrascanner variability was within 628.6%, 613.4% and 62.6% for 3, 5 and $8 mm nodules, respectively. Conclusion: Different 64-MDCT scanners in low-dose settings yield good agreement in volumetry of artificial pulmonary nodules between 5 mm and 12 mm in diameter. Inter-and intrascanner variability decreases at a larger nodule size to a maximum of 4.9% for $8 mm nodules. Advances in knowledge:The commonly accepted cut-off of 25% to determine nodule growth has the potential to be reduced for $8 mm nodules. This offers the possibility of reducing the interval for repeated CT scans in lung cancer screenings.Lung cancer is the primary cancer in males and the second most common cancer in females worldwide, causing 18% of the total number of deaths [1]. Many lung cancers are found at a relatively late stage, resulting in a 5-year survival of only 15% or less [2]. Low-dose CT is a promising screening method for early detection of lung cancer [3][4][5][6][7]. The first result indicates that CT lung cancer screening can reduce lung cancer-specific mortality [8].

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confidence: 99%

Inter- and intrascanner variability of pulmonary nodule volumetry on low-dose 64-row CT: an anthropomorphic phantom study

Xie¹,

Willemink²,

Zhao³

et al. 2013

BJR

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“…Flat-panel scanners outperform multi-detector scanners in pulmonary nodule volumetry, especially in small nodules (< 5 mm) [ 82 – 85 ].…”

Section: Resultsmentioning

confidence: 99%

“…Volumetry is less performant for small nodules [ 10 , 13 , 16 , 18 , 21 , 25 , 28 , 29 , 31 , 36 – 38 , 40 , 41 , 45 , 48 – 51 , 53 , 55 , 56 , 60 , 63 , 70 , 72 , 74 , 78 , 79 , 81 , 82 , 89 , 92 , 93 , 95 – 101 ], explained mainly by partial volume effects, and is considered unreliable for nodules < 5 mm in diameter [ 60 , 102 ].…”

Section: Resultsmentioning

confidence: 99%

Factors influencing the outcome of volumetry tools for pulmonary nodule analysis: a systematic review and attempted meta-analysis

Guedes Pinto,

Penha,

Ravara

et al. 2023

Insights Imaging

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Health systems worldwide are implementing lung cancer screening programmes to identify early-stage lung cancer and maximise patient survival. Volumetry is recommended for follow-up of pulmonary nodules and outperforms other measurement methods. However, volumetry is known to be influenced by multiple factors. The objectives of this systematic review (PROSPERO CRD42022370233) are to summarise the current knowledge regarding factors that influence volumetry tools used in the analysis of pulmonary nodules, assess for significant clinical impact, identify gaps in current knowledge and suggest future research. Five databases (Medline, Scopus, Journals@Ovid, Embase and Emcare) were searched on the 21st of September, 2022, and 137 original research studies were included, explicitly testing the potential impact of influencing factors on the outcome of volumetry tools. The summary of these studies is tabulated, and a narrative review is provided. A subset of studies (n = 16) reporting clinical significance were selected, and their results were combined, if appropriate, using meta-analysis. Factors with clinical significance include the segmentation algorithm, quality of the segmentation, slice thickness, the level of inspiration for solid nodules, and the reconstruction algorithm and kernel in subsolid nodules. Although there is a large body of evidence in this field, it is unclear how to apply the results from these studies in clinical practice as most studies do not test for clinical relevance. The meta-analysis did not improve our understanding due to the small number and heterogeneity of studies testing for clinical significance. Critical relevance statement Many studies have investigated the influencing factors of pulmonary nodule volumetry, but only 11% of these questioned their clinical relevance in their management. The heterogeneity among these studies presents a challenge in consolidating results and clinical application of the evidence. Key points • Factors influencing the volumetry of pulmonary nodules have been extensively investigated. • Just 11% of studies test clinical significance (wrongly diagnosing growth). • Nodule size interacts with most other influencing factors (especially for smaller nodules). • Heterogeneity among studies makes comparison and consolidation of results challenging. • Future research should focus on clinical applicability, screening, and updated technology. Graphical abstract

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“…Prionas et al 32 reached similar conclusions using simulated tumors. Marten et al 33 observed a greater tendency to underestimate nodule volume for smaller nodules. This collective evidence may be relevant, since it indicates that measurements of smaller volumes are less accurate than those of larger ones.…”

Section: Discussionmentioning

confidence: 96%

Validation and comparison of volume measurements using 1 multidetector computed tomography and 5 cone-beam computed tomography protocols: An in vitro study

et al. 2022

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Purpose The purpose of this study was to compare volume measurements obtained using 2 image software packages on Digital Imaging and Communications in Medicine (DICOM) images acquired from 1 multidetector computed tomography and 5 cone-beam computed tomography devices, using different protocols for physical volume measurements. Materials and Methods Four pieces of bovine leg were prepared. Marrow was removed from 3 pieces, leaving cortical bone exposed. The resulting space of 1 piece was filled with water, another was filled with propylene glycol, and the third was left unfilled. The marrow in the fourth sample was left fully intact. Volume measurements were obtained after importing DICOM images into the Dolphin Imaging 11.95 and ITK-SNAP software programs. Data were analyzed using 3-way analysis of variance with a generalized linear model to determine the effects of voxel size, software, and content on percentage mean volume differences between tomographic protocols. A significance level of 0.05 was used. Results The intraclass correlation coefficients for intraobserver and interobserver reliability were, respectively, 0.915 and 0.764 for the Dolphin software and 0.894 and 0.766 for the ITK-SNAP software. Three sources of statistically significant variation were identified: the interaction between software and content ( P =0.001), the main effect of content ( P =0.014), and the main effect of software ( P =0.001). Voxel size was not associated with statistically significant differences in volume measurements. Conclusion Both content and software influenced the accuracy of volume measurements, especially when the content had gray values similar to those of the adjacent tissues.

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Comparison of flat-panel-detector-based CT and multidetector-row CT in automated volumetry of pulmonary nodules using an anthropomorphic chest phantom

Cited by 5 publications

References 23 publications

Inter- and intrascanner variability of pulmonary nodule volumetry on low-dose 64-row CT: an anthropomorphic phantom study

Inter- and intrascanner variability of pulmonary nodule volumetry on low-dose 64-row CT: an anthropomorphic phantom study

Factors influencing the outcome of volumetry tools for pulmonary nodule analysis: a systematic review and attempted meta-analysis

Validation and comparison of volume measurements using 1 multidetector computed tomography and 5 cone-beam computed tomography protocols: An in vitro study

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