Pulmonary nodules: CT evaluation of enhancement with iodinated contrast material

S. J. Swensen, L. R. Brown, T. V. Colby, A. L. Weaver

Research output: Contribution to journalArticle

203 Citations (Scopus)

Abstract

PURPOSE: To determine if the degree of enhancement of pulmonary nodules is directly related to the likelihood of malignancy and to the vascularity of the nodule. MATERIALS AND METHODS: Uncalcified 6-40-mm-diameter pulmonary nodules were studied in 163 patients with malignant neoplasm (n = 111), granuloma (n = 43), and benign neoplasm (n = 9). Serial thin-section computed tomography (CT) was performed before and after injection of 100 mL of nonionic contrast material at 2 mL/sec. The maximum level of enhancement was recorded. Eighteen histologic specimens were graded after vascular staining. RESULTS: Malignant neoplasms enhanced (median, 40.0 HU; range, 20108 HU) significantly more than granulomas and benign neoplasms (median, 12.0 HU; range, -4 to 58 HU) (P < .001). With 20 HU as the threshold for a positive test, sensitivity was 100%; specificity, 76.9%; positive predictive value, 90.2%; negative predictive value, 100%; and accuracy, 92.6% (prevalence of malignancy, 68.1%). Degree of enhancement was significantly related to amount of central vascular staining (P = .003). CONCLUSION: Enhancement is an indicator of malignancy and vascularity.

Original languageEnglish (US)
Pages (from-to)393-398
Number of pages6
JournalRadiology
Volume194
Issue number2
StatePublished - 1995

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Contrast Media
Tomography
Lung
Neoplasms
Granuloma
Blood Vessels
Staining and Labeling
Injections

Keywords

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

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Swensen, S. J., Brown, L. R., Colby, T. V., & Weaver, A. L. (1995). Pulmonary nodules: CT evaluation of enhancement with iodinated contrast material. Radiology, 194(2), 393-398.

Pulmonary nodules : CT evaluation of enhancement with iodinated contrast material. / Swensen, S. J.; Brown, L. R.; Colby, T. V.; Weaver, A. L.

In: Radiology, Vol. 194, No. 2, 1995, p. 393-398.

Research output: Contribution to journalArticle

Swensen, SJ, Brown, LR, Colby, TV & Weaver, AL 1995, 'Pulmonary nodules: CT evaluation of enhancement with iodinated contrast material', Radiology, vol. 194, no. 2, pp. 393-398.
Swensen SJ, Brown LR, Colby TV, Weaver AL. Pulmonary nodules: CT evaluation of enhancement with iodinated contrast material. Radiology. 1995;194(2):393-398.
Swensen, S. J. ; Brown, L. R. ; Colby, T. V. ; Weaver, A. L. / Pulmonary nodules : CT evaluation of enhancement with iodinated contrast material. In: Radiology. 1995 ; Vol. 194, No. 2. pp. 393-398.
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N2 - PURPOSE: To determine if the degree of enhancement of pulmonary nodules is directly related to the likelihood of malignancy and to the vascularity of the nodule. MATERIALS AND METHODS: Uncalcified 6-40-mm-diameter pulmonary nodules were studied in 163 patients with malignant neoplasm (n = 111), granuloma (n = 43), and benign neoplasm (n = 9). Serial thin-section computed tomography (CT) was performed before and after injection of 100 mL of nonionic contrast material at 2 mL/sec. The maximum level of enhancement was recorded. Eighteen histologic specimens were graded after vascular staining. RESULTS: Malignant neoplasms enhanced (median, 40.0 HU; range, 20108 HU) significantly more than granulomas and benign neoplasms (median, 12.0 HU; range, -4 to 58 HU) (P < .001). With 20 HU as the threshold for a positive test, sensitivity was 100%; specificity, 76.9%; positive predictive value, 90.2%; negative predictive value, 100%; and accuracy, 92.6% (prevalence of malignancy, 68.1%). Degree of enhancement was significantly related to amount of central vascular staining (P = .003). CONCLUSION: Enhancement is an indicator of malignancy and vascularity.

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