Comparison of maximum intensity projection and volume rendering on multidetector computed tomography in detecting pulmonary nodules

Abstract

Background Lung cancer is the one of the most common types of cancer and considered as a leading cause of death from neoplasms. Almost all types of lung cancer develop from pulmonary nodules. The wide availability of the multi-detector computed tomography (MDCT) scanners makes the detection of pulmonary nodules much easier. Volume rendering (VR) and maximum intensity projection (MIP) techniques are the most commonly used post-processing techniques. The purpose of this research is to compare and contrast the two techniques in terms of the number and size of nodules. Results In the current study, 32 patients with pulmonary nodules were included being referred from the chest department, with their age ranging from 27 to 71 years old. Nodules characteristics, such as number and size, were evaluated on both MIP and VR techniques. Paired comparison of number of pulmonary nodules less than 6 mm between MIP and VR showed statistically significant difference in 4, 7 and 10 mm slip thickness with P-value 0.003, 0.0001 and 0.0001, respectively. Paired comparison of number of pulmonary nodules more than 6 mm in size between MIP and VR showed no statistically significant difference in 4, 7 and 10 mm slip thickness with P-value > 0.05 each. Comparison of the pulmonary nodules numbers according to slip thickness showed that there was a statistically significant difference in the number of detected nodules, showing that 10 mm slip thickness is significantly higher compared to 4 mm and 7 mm with P-value 0.0001, 0.0001 for nodules < 6 mm, and 0.001 for the lung nodules > 6 mm in size. Conclusions We can conclude the superiority of MIP over VR in detection of small sized nodules. MIP was easier to follow and showed high inter-reader agreement. The 10 mm MIP outperformed all other slab thicknesses for nodule detection less than 6 mm. There was no statistically significant difference between both techniques in terms of larger nodules measuring > 6 mm.