Lung nodule enhancement at CT: Prospective findings

Stephen J. Swensen, Larry R. Brown, Thomas V. Colby, Amy L. Weaver, David E. Midthun

Research output: Contribution to journalArticle

236 Scopus citations

Abstract

PURPOSE: To determine if lung nodule enhancement measured with computed tomography (CT) is directly related to the likelihood of malignancy and to nodule vascularity. MATERIALS AND METHODS: Radiologically indeterminate 7- 30-mm pulmonary nodules were studied in 107 patients with malignant neoplasms (n = 52), granulomas (n = 51), and benign neoplasms (n = 4). Attenuation was recorded from serial thin-section CT scans before and after injection of contrast material. Twenty-four histologic specimens were graded after immunoperoxidase vascular staining with antibody to factor VIII-associated antigen. RESULTS: Malignant neoplasms were enhanced (median, 46.5 HU; range, 11-110 HU) statistically significantly more than granulomas and benign neoplasms (median, 8 HU; range, -10 to 94 HU) (P < .001). With 20 HU as the threshold for a positive test result, the sensitivity was 98%, specificity was 73%, and accuracy was 85% (prevalence of malignancy, 49% [52 of 107 nodules]). The degree of enhancement was statistically significantly related to the amount of central vascular staining (P < .001). CONCLUSION: Enhancement appears to be an indicator of malignancy and vascularity. These prospective findings corroborate previously reported results.

Original languageEnglish (US)
Pages (from-to)447-455
Number of pages9
JournalRadiology
Volume201
Issue number2
DOIs
StatePublished - Nov 1996

Keywords

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Swensen, S. J., Brown, L. R., Colby, T. V., Weaver, A. L., & Midthun, D. E. (1996). Lung nodule enhancement at CT: Prospective findings. Radiology, 201(2), 447-455. https://doi.org/10.1148/radiology.201.2.8888239