Lung nodule enhancement at CT: Multicenter study

Stephen J. Swensen; Robert W. Viggiano; David E. Midthun; Nestor L. Müller; Andrew Sherrick; Keiji Yamashita; David P. Naidich; Edward F. Patz; Thomas E. Hartman; John R. Muhm; Amy L. Weaver

doi:10.1148/radiology.214.1.r00ja1473

Lung nodule enhancement at CT: Multicenter study

Stephen J. Swensen, Robert W. Viggiano, David E. Midthun, Nestor L. Müller, Andrew Sherrick, Keiji Yamashita, David P. Naidich, Edward F. Patz, Thomas E. Hartman, John R. Muhm, Amy L. Weaver

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Abstract

PURPOSE: To test the hypothesis that absence of statistically significant lung nodule enhancement (≤15 HU) at computed tomography (CT) is strongly predictive of benignity. MATERIALS AND METHODS: Five hundred fifty lung nodules were studied. Of these, 356 met all entrance criteria and had a diagnosis. On nonenhanced, thin-section CT scans, the nodules were solid, 5- 40 mm in diameter, relatively spherical, homogeneous, and without calcification or fat. All patients were examined with 3-mm-collimation CT before and after intravenous injection of contrast material. CT scans through the nodule were obtained at 1, 2, 3, and 4 minutes after the onset of injection. Peak net nodule enhancement and time-attenuation curves were analyzed. Seven centers participated. RESULTS: The prevalence of malignancy was 48% (171 of 356 nodules). Malignant neoplasms enhanced (median, 38.1 HU; range, 14.0-165.3 HU) significantly more than granulomas and benign neoplasms (median, 10.0 HU; range, -20.0 to 96.0 HU; P < .001). With 15 HU as the threshold, the sensitivity was 98% (167 of 171 malignant nodules), the specificity was 58% (107 of 185 benign nodules), and the accuracy was 77% (274 of 356 nodules). CONCLUSION: Absence of significant lung nodule enhancement (≤15 HU) at CT is strongly predictive of benignity.

Original language	English (US)
Pages (from-to)	73-80
Number of pages	8
Journal	Radiology
Volume	214
Issue number	1
DOIs	https://doi.org/10.1148/radiology.214.1.r00ja1473
State	Published - 2000

Keywords

Lung neoplasms, CT
Lung neoplasms, diagnosis
Lung, CT
Lung, nodule

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

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10.1148/radiology.214.1.r00ja1473

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@article{74c060d045314c4292c287220f33b73e,

title = "Lung nodule enhancement at CT: Multicenter study",

abstract = "PURPOSE: To test the hypothesis that absence of statistically significant lung nodule enhancement (≤15 HU) at computed tomography (CT) is strongly predictive of benignity. MATERIALS AND METHODS: Five hundred fifty lung nodules were studied. Of these, 356 met all entrance criteria and had a diagnosis. On nonenhanced, thin-section CT scans, the nodules were solid, 5- 40 mm in diameter, relatively spherical, homogeneous, and without calcification or fat. All patients were examined with 3-mm-collimation CT before and after intravenous injection of contrast material. CT scans through the nodule were obtained at 1, 2, 3, and 4 minutes after the onset of injection. Peak net nodule enhancement and time-attenuation curves were analyzed. Seven centers participated. RESULTS: The prevalence of malignancy was 48% (171 of 356 nodules). Malignant neoplasms enhanced (median, 38.1 HU; range, 14.0-165.3 HU) significantly more than granulomas and benign neoplasms (median, 10.0 HU; range, -20.0 to 96.0 HU; P < .001). With 15 HU as the threshold, the sensitivity was 98% (167 of 171 malignant nodules), the specificity was 58% (107 of 185 benign nodules), and the accuracy was 77% (274 of 356 nodules). CONCLUSION: Absence of significant lung nodule enhancement (≤15 HU) at CT is strongly predictive of benignity.",

keywords = "Lung neoplasms, CT, Lung neoplasms, diagnosis, Lung, CT, Lung, nodule",

author = "Swensen, {Stephen J.} and Viggiano, {Robert W.} and Midthun, {David E.} and M{\"u}ller, {Nestor L.} and Andrew Sherrick and Keiji Yamashita and Naidich, {David P.} and Patz, {Edward F.} and Hartman, {Thomas E.} and Muhm, {John R.} and Weaver, {Amy L.}",

year = "2000",

doi = "10.1148/radiology.214.1.r00ja1473",

language = "English (US)",

volume = "214",

pages = "73--80",

journal = "Radiology",

issn = "0033-8419",

publisher = "Radiological Society of North America Inc.",

number = "1",

}

TY - JOUR

T1 - Lung nodule enhancement at CT

T2 - Multicenter study

AU - Swensen, Stephen J.

AU - Viggiano, Robert W.

AU - Midthun, David E.

AU - Müller, Nestor L.

AU - Sherrick, Andrew

AU - Yamashita, Keiji

AU - Naidich, David P.

AU - Patz, Edward F.

AU - Hartman, Thomas E.

AU - Muhm, John R.

AU - Weaver, Amy L.

PY - 2000

Y1 - 2000

N2 - PURPOSE: To test the hypothesis that absence of statistically significant lung nodule enhancement (≤15 HU) at computed tomography (CT) is strongly predictive of benignity. MATERIALS AND METHODS: Five hundred fifty lung nodules were studied. Of these, 356 met all entrance criteria and had a diagnosis. On nonenhanced, thin-section CT scans, the nodules were solid, 5- 40 mm in diameter, relatively spherical, homogeneous, and without calcification or fat. All patients were examined with 3-mm-collimation CT before and after intravenous injection of contrast material. CT scans through the nodule were obtained at 1, 2, 3, and 4 minutes after the onset of injection. Peak net nodule enhancement and time-attenuation curves were analyzed. Seven centers participated. RESULTS: The prevalence of malignancy was 48% (171 of 356 nodules). Malignant neoplasms enhanced (median, 38.1 HU; range, 14.0-165.3 HU) significantly more than granulomas and benign neoplasms (median, 10.0 HU; range, -20.0 to 96.0 HU; P < .001). With 15 HU as the threshold, the sensitivity was 98% (167 of 171 malignant nodules), the specificity was 58% (107 of 185 benign nodules), and the accuracy was 77% (274 of 356 nodules). CONCLUSION: Absence of significant lung nodule enhancement (≤15 HU) at CT is strongly predictive of benignity.

AB - PURPOSE: To test the hypothesis that absence of statistically significant lung nodule enhancement (≤15 HU) at computed tomography (CT) is strongly predictive of benignity. MATERIALS AND METHODS: Five hundred fifty lung nodules were studied. Of these, 356 met all entrance criteria and had a diagnosis. On nonenhanced, thin-section CT scans, the nodules were solid, 5- 40 mm in diameter, relatively spherical, homogeneous, and without calcification or fat. All patients were examined with 3-mm-collimation CT before and after intravenous injection of contrast material. CT scans through the nodule were obtained at 1, 2, 3, and 4 minutes after the onset of injection. Peak net nodule enhancement and time-attenuation curves were analyzed. Seven centers participated. RESULTS: The prevalence of malignancy was 48% (171 of 356 nodules). Malignant neoplasms enhanced (median, 38.1 HU; range, 14.0-165.3 HU) significantly more than granulomas and benign neoplasms (median, 10.0 HU; range, -20.0 to 96.0 HU; P < .001). With 15 HU as the threshold, the sensitivity was 98% (167 of 171 malignant nodules), the specificity was 58% (107 of 185 benign nodules), and the accuracy was 77% (274 of 356 nodules). CONCLUSION: Absence of significant lung nodule enhancement (≤15 HU) at CT is strongly predictive of benignity.

KW - Lung neoplasms, CT

KW - Lung neoplasms, diagnosis

KW - Lung, CT

KW - Lung, nodule

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DO - 10.1148/radiology.214.1.r00ja1473

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AN - SCOPUS:0033962497

SN - 0033-8419

VL - 214

SP - 73

EP - 80

JO - Radiology

JF - Radiology

IS - 1

ER -

Lung nodule enhancement at CT: Multicenter study

Abstract

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