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Detection of pulmonary nodules by multislice computed tomography: improved detection rate with reduced slice thickness.

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Title: Detection of pulmonary nodules by multislice computed tomography: improved detection rate with reduced slice thickness.
Authors: Fischbach, Frank1, Knollmann, Friedrich1, Griesshaber, Volker1, Freund, Torsten1, Akkol, Ethem1, Felix, Roland1
Source: European Radiology. Oct2003, Vol. 13 Issue 10, p2378-2383. 6p.
Subjects: Lung diseases, Diseases, Physicians, Radiologists, Patients, Money, Comparative studies, Computed tomography, Confidence intervals, Diagnostic imaging, Longitudinal method, Lung tumors, Research methodology, Medical cooperation, Computers in medicine, Research, Statistical sampling, Tumor classification, Three-dimensional imaging, Evaluation research, Research bias, Solitary pulmonary nodule
Abstract: The purpose of this study was to find out if the use of 1.25-mm collimated thin-slice technique helps to detect more small pulmonary lung nodules than the use of 5 mm. A total of 100 patient examinations that allowed a reconstruction of 1.25-mm slice thickness in addition to the standard of 5-mm slices were included in a prospective study. Acquisition technique included four rows of 1-mm slices. Two sets of contiguous images were reconstructed and compared with 1.25- and 5-mm slice thickness, respectively. Two radiologists performed a film-based analysis of the images. The size and the confidence of the seen nodules were reported. We did not perform a histological verification, according to the normal clinical procedure, although it would be optimal regarding research. Statistical analysis was performed by using longitudinal analysis described by Brunner and Langer [10]. In addition, sensitivity, specificity, negative predictive value and positive predictive value were calculated for each reader using the 1.25-mm sections as the gold standard. As an index for concordance the kappa value was used. A value of p<0.05 was regarded as significant. In 37 patients pulmonary nodules were detected. Twenty-four patients showed more than one nodule; among these, 7 patients had disseminated disease and were excluded from the study. Pulmonary nodules larger than 10 mm in size were equally well depicted with both modalities, whereas lesions smaller than 5 mm in size were significantly better depicted with 1.25 mm (p<0.05). Using 1.25 mm as the gold standard, sensitivity for 5-mm reconstruction interval was 88 and 86% for observers A and B, respectively. No false-positive results were reported for 5-mm sections. Interobserver agreement for nodule detection determined for 1.25-mm reconstruction intervals showed a k value of 0.753, indicating a good agreement, and 0.562 for 5-mm reconstruction intervals, indicating a moderate agreement. Brunner and Langer [10] analysis showed significant differences for slice thickness and no significant difference between the observers. Reduced slice thickness demonstrated an improvement of small nodule detection, confidence levels, and interobserver agreement. Application of thin-slice multidetector-row CT may raise the sensitivity for lung nodule detection, although the higher detection rate of smaller nodules has to be evaluated from a clinical perspective and remains problematic about how the detection of small nodules will effect patient outcome. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The purpose of this study was to find out if the use of 1.25-mm collimated thin-slice technique helps to detect more small pulmonary lung nodules than the use of 5 mm. A total of 100 patient examinations that allowed a reconstruction of 1.25-mm slice thickness in addition to the standard of 5-mm slices were included in a prospective study. Acquisition technique included four rows of 1-mm slices. Two sets of contiguous images were reconstructed and compared with 1.25- and 5-mm slice thickness, respectively. Two radiologists performed a film-based analysis of the images. The size and the confidence of the seen nodules were reported. We did not perform a histological verification, according to the normal clinical procedure, although it would be optimal regarding research. Statistical analysis was performed by using longitudinal analysis described by Brunner and Langer [10]. In addition, sensitivity, specificity, negative predictive value and positive predictive value were calculated for each reader using the 1.25-mm sections as the gold standard. As an index for concordance the kappa value was used. A value of p&lt;0.05 was regarded as significant. In 37 patients pulmonary nodules were detected. Twenty-four patients showed more than one nodule; among these, 7 patients had disseminated disease and were excluded from the study. Pulmonary nodules larger than 10 mm in size were equally well depicted with both modalities, whereas lesions smaller than 5 mm in size were significantly better depicted with 1.25 mm (p&lt;0.05). Using 1.25 mm as the gold standard, sensitivity for 5-mm reconstruction interval was 88 and 86% for observers A and B, respectively. No false-positive results were reported for 5-mm sections. Interobserver agreement for nodule detection determined for 1.25-mm reconstruction intervals showed a k value of 0.753, indicating a good agreement, and 0.562 for 5-mm reconstruction intervals, indicating a moderate agreement. Brunner and Langer [10] analysis showed significant differences for slice thickness and no significant difference between the observers. Reduced slice thickness demonstrated an improvement of small nodule detection, confidence levels, and interobserver agreement. Application of thin-slice multidetector-row CT may raise the sensitivity for lung nodule detection, although the higher detection rate of smaller nodules has to be evaluated from a clinical perspective and remains problematic about how the detection of small nodules will effect patient outcome. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – TitleFull: Detection of pulmonary nodules by multislice computed tomography: improved detection rate with reduced slice thickness.
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