Purpose
1. The evaluation of the rate of growth of pulmonary nodules through “doubling time” is an important parameter to distinguish between benign and malignant lesions and to estimate the response to antiblastic therapy of pulmonary metastases. 2. Literature of last years confirmed the superiority of three-dimensional volumetric measures respect to bi-dimensional ones (based on measurement of maximum diameter or maximum sectional area of the lesion) [references 1-4]. By this, there was an implementation of dedicated automated or semi-automated segmentation softwares, that improved the work of...
Methods and Materials
The data set included 109 pulmonary nodules, diameter between 4 and 30 mm, obtained by CT scan of the thorax of 44 consecutive patients (twenty-four men and twenty women, mean age of 57,6 years, range 36-82) . Thirty-three of the 44 patients of the study population had solitary pulmonary nodules (SPNs) casually detected in chest X-ray or CT examinations performed because of other pathologic conditions (BPCO, suspicion of pulmonary embolism, pulmonary symptoms), with no story of cancer. We also detected secondary lesions in 9 patients...
Results
The 109 pulmonary nodules were classified by a consensus of two radiologists according their size, relation with surrounding lung parenchyma and neighbouring structures (nodule type), structure (density) and margins based on visual analysis of the 1.25mm thick axial images.1) size (maximum axial diameter) : 0,9% <5mm (n=1); 28,4% >5< 10 mm (n= 31); 35,7% >=10<15 mm (n= 39); 12,8% >015<18 mm (n=14); 22% >18<30 mm (n=24) (Table 2).2) relation with surrounding lung parenchyma and neighbouring structure (also called type): well circumscribed (n= 16); iuxta-vascular (n=...
Conclusion
A reproducible 3D volumetric estimation of pulmonary nodules with thoracic CT require a carefully selection of technical parameters. For a wide clinical application of 3D volumetric assessment of lung nodule, the researchers should be interested not only to optimize the CT technique but also to make the volumetric analysis reproducible with different softwares [references 21, 22].
References
Yankelevitz DF, Reeves AP, Kostis WJ et al. Small Pulmonary Nodules: volumetrically determined growth rates based on CT evaluation. Radiology 2000, 217:251-256. Kostis WJ, Yankelevitz DF, Reeves AP et al. Small Pulmonary Nodules: Reproducibility of Three-dimensional Volumetric Measurement and Estimation of Time to Follow-up CT. Radiology 2004, 231: 446-452. Volterrani L, Mazzei MA, Scialpi M, et al. Three-dimensional analysis of pulmonary nodules by MSCT with Advanced Lung Analysis (ALA1) software. Radiol Med (2006) 111:343-3546. Ravel MP, Lefort C, Bissry Aet al. Pulmonary nodules: preliminary experience...
Personal Information
Maria Antonietta Mazzei,Assistant Professor of Radiology,Department of Human Pathology and Oncology, Section of Radiology,University of Siena,
[email protected]