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  1. Article: Lung nodule enhancement at CT: multicenter study.

    Swensen, S J / Viggiano, R W / Midthun, D E / Müller, N L / Sherrick, A / Yamashita, K / Naidich, D P / Patz, E F / Hartman, T E / Muhm, J R / Weaver, A L

    Radiology

    2000  Volume 214, Issue 1, Page(s) 73–80

    Abstract: Purpose: To test the hypothesis that absence of statistically significant lung nodule enhancement (< or =15 HU) at computed tomography (CT) is strongly predictive of benignity.: Materials and methods: Five hundred fifty lung nodules were studied. Of ... ...

    Abstract Purpose: To test the hypothesis that absence of statistically significant lung nodule enhancement (< or =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 (< or = 15 HU) at CT is strongly predictive of benignity.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Contrast Media ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms/diagnostic imaging ; Male ; Middle Aged ; Prospective Studies ; Radiographic Image Enhancement ; Sensitivity and Specificity ; Solitary Pulmonary Nodule/diagnostic imaging ; Tomography, X-Ray Computed
    Chemical Substances Contrast Media
    Language English
    Publishing date 2000-01
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 80324-8
    ISSN 1527-1315 ; 0033-8419
    ISSN (online) 1527-1315
    ISSN 0033-8419
    DOI 10.1148/radiology.214.1.r00ja1473
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Lung nodules: dual-kilovolt peak analysis with CT--multicenter study.

    Swensen, S J / Yamashita, K / McCollough, C H / Viggiano, R W / Midthun, D E / Patz, E F / Muhm, J R / Weaver, A L

    Radiology

    2000  Volume 214, Issue 1, Page(s) 81–85

    Abstract: Purpose: To test the following hypothesis: The greater the increase in the mean computed tomographic (CT) number of a radiologically indeterminate lung nodule from the CT number on a 140-kVp CT image to that on an 80-kVp CT image, the more likely the ... ...

    Abstract Purpose: To test the following hypothesis: The greater the increase in the mean computed tomographic (CT) number of a radiologically indeterminate lung nodule from the CT number on a 140-kVp CT image to that on an 80-kVp CT image, the more likely the nodule is benign (ie, contains calcium).
    Materials and methods: Two hundred forty indeterminate lung nodules were prospectively studied at four institutions: Mayo Clinic Scottsdale, Ariz (n = 160); Mayo Clinic Rochester, Minn (n = 50); Shiga Health Insurance Hospital, Otsu, Japan (n = 25); and Duke University Medical Center, Durham, NC (n = 5). Of the 240 nodules, 157 met the entrance criteria for this study and had a diagnosis. All nodules included were solid, 5-40-mm diameter, relatively spherical, homogeneous, and without visible evidence of calcification or fat. Each nodule was evaluated by using 3-mm-collimation, nonenhanced CT scans with both 140- and 80-kVp x-ray beams.
    Results: There were 86 (55%) benign and 71 (45%) malignant nodules. The median increase in the nodule mean CT number from the CT number on 140-kVp images to that on 80-kVp images was 2 HU for benign nodules and 3 HU for malignant nodules. This difference was not statistically significant. The area under the receiver operating characteristic curve was 0.505.
    Conclusion: Dual-kilovolt peak analysis with current CT technology does not appear to be helpful in the identification of benign lung nodules.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Calcinosis/diagnostic imaging ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms/diagnostic imaging ; Male ; Middle Aged ; Prospective Studies ; Radiographic Image Enhancement ; Sensitivity and Specificity ; Solitary Pulmonary Nodule/diagnostic imaging ; Tomography, X-Ray Computed
    Language English
    Publishing date 2000-01
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 80324-8
    ISSN 1527-1315 ; 0033-8419
    ISSN (online) 1527-1315
    ISSN 0033-8419
    DOI 10.1148/radiology.214.1.r00ja2681
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Prospective comparison of helical CT and MR imaging in clinically suspected acute pulmonary embolism.

    Sostman, H D / Layish, D T / Tapson, V F / Spritzer, C E / DeLong, D M / Trotter, P / MacFall, J R / Patz, E F / Goodman, P C / Woodard, P K / Foo, T K / Farber, J L

    Journal of magnetic resonance imaging : JMRI

    1996  Volume 6, Issue 2, Page(s) 275–281

    Abstract: The purpose of this study is to compare sensitivity and specificity of helical CT and MR imaging for detecting acute pulmonary embolism(PE). Patients who were suspected clinically of having PE were randomly assigned to undergo either helical contrast- ... ...

    Abstract The purpose of this study is to compare sensitivity and specificity of helical CT and MR imaging for detecting acute pulmonary embolism(PE). Patients who were suspected clinically of having PE were randomly assigned to undergo either helical contrast-enhanced CT or gradient-echo MR (if one modality was contraindicated, the patient was assigned to the other.) Patients were considered to have PE if they had: 1) high-probability V-Q scan and low clinical probability of PE; 2) pulmonary angiogram positive for PE. Patients were considered not to have PE if they had either:1)normal V-Q scan; 2) low probability V-Q scan and low clinical probability of PE; or 3) pulmonary angiogram negative for PE. The CT and MR images were read randomly and independently by five radiologists with varying levels of CT and MR experience. Twenty eight patients underwent CT and 25 MR. A total of 21 patients underwent pulmonary angiography (6 had PE, 15 did not have PE). Of the other 32 patients, 15 had high probability scan/high clinical probability and 17 had low probability scan/low clinical probability. For the five observers, the average sensitivity of CT was 75% and of MR 46%; the average specificity of CT was 89% and of MR 90%. Experience with vascular MR and enhanced CT influenced diagnostic accuracy. For the two vascular MR experts, average sensitivity and specificity of MR were 71% and 97%, and of CT 73% and 97%. In this pilot study, when CT and MR were interpreted with comparable expertise, they had similar accuracy for detecting pulmonary embolism.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Image Processing, Computer-Assisted ; Lung/pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pilot Projects ; Prospective Studies ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/diagnostic imaging ; Sensitivity and Specificity ; Tomography, X-Ray Computed/methods
    Language English
    Publishing date 1996-03
    Publishing country United States
    Document type Clinical Trial ; Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 1146614-5
    ISSN 1522-2586 ; 1053-1807
    ISSN (online) 1522-2586
    ISSN 1053-1807
    DOI 10.1002/jmri.1880060203
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3648: Show issues Location:
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    Zs.MO 236: Show issues

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  4. Article: Detection of pulmonary embolism: comparison of contrast-enhanced spiral CT and time-of-flight MR techniques.

    Woodard, P K / Sostman, H D / MacFall, J R / DeLong, D M / McDonald, J W / Foo, T K / Patz, E F / Goodman, P C / Spritzer, C E

    Journal of thoracic imaging

    1995  Volume 10, Issue 1, Page(s) 59–72

    Abstract: We compared the conspicuity of acute pulmonary emboli with contrast-enhanced spiral computed tomography (CT) and two- and three-dimensional time-of-flight magnetic resonance (MR) techniques. Seven dogs who received experimental pulmonary emboli and one ... ...

    Abstract We compared the conspicuity of acute pulmonary emboli with contrast-enhanced spiral computed tomography (CT) and two- and three-dimensional time-of-flight magnetic resonance (MR) techniques. Seven dogs who received experimental pulmonary emboli and one control were imaged with spiral CT and with 2-D (FMPVAS and FASTCARD) and 3-D time-of-flight MR. Blinded, independent, prospective evaluations of the CT and MR images by two MR radiologists and two chest radiologists were then compared to the location of the emboli as determined by subsequent pathologic evaluation of the excised lungs. Embolus/blood contrast-to-noise ratios (CNRs) were calculated on both MR and CT images for pulmonary emboli that could be identified. Fifty emboli ranging from 1.0 to 5.5 mm (mean, 2.7, +/- 0.14 SEM) in diameter and from 3.0 to 60 mm (mean, 28.1 +/- 1.9 SEM) in length were found in the seven embolized dogs on pathologic examination. Three of the four radiologists identified more thrombi on CT images than they did on their best MR pulse sequence (FASTCARD) and with greater confidence. The fourth radiologist identified an equal percentage of clot on CT and FASTCARD images with confidence slightly greater on FASTCARD MR than on spiral CT. Mean CNR for the best MR technique was 43.4 (+/- 3.9 SEM) and for CT was 20.7 (+/- 1.3 SEM). In general, pulmonary emboli were detected more accurately on contrast-enhanced spiral CT than on MR. This occurred although the embolus/blood CNR was higher on MR than on CT. Better pulmonary embolus conspicuity on CT images was attributed to better spatial resolution and fewer artifacts on CT than on MR. One MR radiologist performed equally well with both spiral CT and FASTCARD techniques, suggesting that experience may be a factor in performance.
    MeSH term(s) Animals ; Dogs ; Female ; Magnetic Resonance Imaging ; Observer Variation ; Prospective Studies ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/diagnostic imaging ; Single-Blind Method ; Tomography, X-Ray Computed
    Language English
    Publishing date 1995
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 632900-7
    ISSN 1536-0237 ; 0883-5993
    ISSN (online) 1536-0237
    ISSN 0883-5993
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2187: Show issues Location:
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