Pulmonary Nodules With Ground-Glass Opacity Can Be Reliably Measured With Low-Dose Techniques Regardless of Iterative Reconstruction: Results of a Phantom Study

Siegelman, Jenifer; Supanich, Mark; Gavrielides, Marios A.

doi:10.2214/ajr.14.13820

Cited by 23 publications

(19 citation statements)

References 27 publications

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“…At the same time, we wanted to provide some insight into any potential limit in the "measurability" of lung nodules, by stretching the range of dose protocols to as low as 0.3 mGy, the range of nodule sizes to 5 mm, and densities as low as −800 HU. Assessment was performed to quantify the accuracy and precision of volume estimates; both of these properties need to be within acceptable boundaries for a clinically useful biomarker (23). Our findings show that the volume of the 10 mm nodules of all densities was measured with both high accuracy (PB within 11%) and high precision (RC% within 5%).…”

Section: Discussionmentioning

confidence: 85%

“…We limited our review of related work to phantom studies, which enable the analysis of both accuracy and precision due to the availability of a reference standard regarding nodule size and allow the acquisition of multiple repeated scans without concern to patient exposure. Li et al (6), Doo et al (22), and Siegelman et al (23) examined the volumetry of low-density nodules across different imaging protocols, but the lowest nodule density was limited to −630 HU. Scholten et al (18) and Linning et al (24) did not examine the effect of different reconstruction methods beyond FBP.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative assessment of nonsolid pulmonary nodule volume with computed tomography in a phantom study

Gavrielides

Berman

Supanich

et al. 2017

Quant. Imaging Med. Surg.

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Background: To assess the volumetric measurement of small (≤1 cm) nonsolid nodules with computed tomography (CT), focusing on the interaction of state of the art iterative reconstruction (IR) methods and dose with nodule densities, sizes, and shapes. Results: Density had the most important effect on measurement error followed by the interaction of density with nodule size. The nonsolid −630 HU nodules had high accuracy and precision at levels comparable to solid (−10 HU) nonsolid, regardless of reconstruction method and with CTDI vol as low as 0.6 mGy. PB was <5% and <11% for the 10-and 5-mm in nominal diameter −630 HU nodules respectively, and RC was <5% and <12% for the same nodules. For nonsolid −800 HU nodules, PB increased to <11% and <30% for the 10-and 5-mm nodules respectively, whereas RC increased slightly overall but varied widely across dose and reconstruction algorithms for the 5-mm nodules. Model-based IR improved measurement accuracy for the 5-mm, low-density (−800, −630 HU) nodules. For other nodules the effect of reconstruction method was small. Dose did not affect volumetric accuracy and only affected slightly the precision of 5-mm nonsolid nodules.Conclusions: Reasonable values of both accuracy and precision were achieved for volumetric measurements of all 10-mm nonsolid nodules, and for the 5-mm nodules with −630 HU or higher density, when derived from scans acquired with below screening dose levels as low as 0.6 mGy and regardless of reconstruction algorithm.

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Quantitative assessment of nonsolid pulmonary nodule volume with computed tomography in a phantom study

Gavrielides

Berman

Supanich

et al. 2017

Quant. Imaging Med. Surg.

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“…23 Doo et al 23 showed that IR significantly improved the accuracy of lung nodule volumetry in low-dose CT compared with FBP, particularly for ground-glass nodules (2630 HU). Also, Siegelmann et al 24 in a recent work state that pulmonary nodules with groundglass opacity can be reliably measured with low-dose techniques down to a CTDI vol of 0.8 mGy regardless of IR. Willemink et al 25 found that with IR no clinically significant differences between lung nodule volumes are evident.…”

Section: Discussionmentioning

confidence: 99%

Ultralow-dose CT with tin filtration for detection of solid and sub solid pulmonary nodules: a phantom study

Martini

Higashigaito

Barth

et al. 2015

BJR

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Objectives: To investigate the diagnostic performance of advanced modelled iterative reconstruction (ADMIRE) to filtered back projection (FBP) when using an ultralow-dose protocol for the detection of solid and subsolid pulmonary nodules. Methods: Single-energy CT was performed at 100 kVp with tin filtration in an anthropomorphic chest phantom with solid and subsolid pulmonary nodules (2-10 mm, attenuation, 20 to 2800 HU at 120 kVp). The mean volume CT dose index (CTDI vol ) of the standard chest protocol was 2.2 mGy. Subsequent scans were obtained at 1/8 (0.28 mGy), 1/20 (0.10 mGy) and 1/70 (0.03 mGy) dose levels by lowering tube voltage and tube current. Images were reconstructed with FBP and ADMIRE. One reader measured image noise; two readers determined image quality and assessed nodule localization.Results: Image noise was significantly reduced using ADMIRE compared with FBP (ADMIRE at a strength level of 5 : 70.4% for 1/20; 71.6% for 1/8; p , 0.001). Interobserver agreement for image quality was excellent (k 5 0.88). Image quality was considered diagnostic for all images at 1/20 dose using ADMIRE. Sensitivity of nodule detection was 97.1% (100% for solid, 93.8% for subsolid nodules) at 1/20 dose and 100% for both nodule entities at 1/8 dose using ADMIRE 5. Images obtained with 1/70 dose had moderate sensitivity (overall 85.7%; solid 95%; subsolid 73.3%). Conclusion: Our study suggests that with a combination of tin filtration and ADMIRE, the CTDI vol of chest CT can be lowered considerably, while sensitivity for nodule detection remains high. For solid nodules, CTDI vol was 0.10 mGy, while subsolid nodules required a slightly higher CTDI vol of 0.28 mGy. Advances in knowledge: Detection of subsolid nodules is feasible with ultralow-dose protocols.

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“…A larger number of results derived from studies using newer generation scanners did not confirm the previous observations. Indeed, the introduction of iterative reconstructions, employed to increase image quality in favour of a further reduction of the effective radiation dose, demonstrated an even better performance compared to that of the traditionally used filtered-back projection reconstructions [101][102][103][104][105][106][107][108][109][110][111][112].…”

Section: Factors Influencing Nodule Measurement Variationsmentioning

confidence: 99%

Lung nodules: size still matters

et al. 2017

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The incidence of indeterminate pulmonary nodules has risen constantly over the past few years. Determination of lung nodule malignancy is pivotal, because the early diagnosis of lung cancer could lead to a definitive intervention. According to the current international guidelines, size and growth rate represent the main indicators to determine the nature of a pulmonary nodule. However, there are some limitations in evaluating and characterising nodules when only their dimensions are taken into account. There is no single method for measuring nodules, and intrinsic errors, which can determine variations in nodule measurement and in growth assessment, do exist when performing measurements either manually or with automated or semi-automated methods. When considering subsolid nodules the presence and size of a solid component is the major determinant of malignancy and nodule management, as reported in the latest guidelines. Nevertheless, other nodule morphological characteristics have been associated with an increased risk of malignancy. In addition, the clinical context should not be overlooked in determining the probability of malignancy. Predictive models have been proposed as a potential means to overcome the limitations of a sized-based assessment of the malignancy risk for indeterminate pulmonary nodules.

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Pulmonary Nodules With Ground-Glass Opacity Can Be Reliably Measured With Low-Dose Techniques Regardless of Iterative Reconstruction: Results of a Phantom Study

Abstract: These results indicate that, if validated for other measurement tools and scanners, lung nodule volume measurements from scans acquired and reconstructed with significantly different acquisition and reconstruction techniques can be reliably compared.

Cited by 23 publications

References 27 publications

Quantitative assessment of nonsolid pulmonary nodule volume with computed tomography in a phantom study

Quantitative assessment of nonsolid pulmonary nodule volume with computed tomography in a phantom study

Ultralow-dose CT with tin filtration for detection of solid and sub solid pulmonary nodules: a phantom study

Lung nodules: size still matters

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