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Parillo M, Vertulli D, Vaccarino F, Mallio CA, Beomonte Zobel B, Quattrocchi CC. The sensitivity of MIPs of 3D contrast-enhanced VIBE T1-weighted imaging for the detection of small brain metastases (≤ 5 mm) on 1.5 tesla MRI. Neuroradiol J 2024:19714009241260802. [PMID: 38861176 DOI: 10.1177/19714009241260802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES To evaluate whether the use of Maximum Intensity Projection (MIP) images derived from contrast-enhanced 3D-T1-weighted volumetric interpolated breath-hold examination (VIBE) would allow more sensitive detection of small (≤5 mm) brain metastases (BM) compared with source as well as 2D-T1-weighted spin-echo (SE) images. METHODS We performed a single center retrospective study on subjects with BM who underwent 1.5 tesla brain magnetic resonance imaging. Two readers counted the number of small BM for each of the seven sets of contrast-enhanced images created: axial 2D-T1-weighted SE, 3D-T1-weighted VIBE, 2.5 mm-thick-MIP T1-weighted VIBE, and 5 mm-thick-MIP T1-weighted VIBE; sagittal 3D-T1-weighted VIBE, 2.5 mm-thick-MIP T1-weighted VIBE, and 5 mm-thick-MIP T1-weighted VIBE. Total number of lesions detected on each image type was compared. Sensitivity, the average rates of false negatives and false positives, and the mean discrepancy were evaluated. RESULTS A total of 403 small BM were identified in 49 patients. Significant differences were found: in the number of true positives and false negatives between the axial 2D-T1-weighted SE sequence and all other imaging techniques; in the number of false positives between the axial 2D-T1-weighted SE and the axial 3D-T1-weighted VIBE sequences. The two image types that combined offered the highest sensitivity were 2D-T1-weighted SE and axial 2.5 mm-thick-MIP T1-weighted VIBE. The axial 2D-T1-weighted SE sequence differed significantly in sensitivity from all other sequences. CONCLUSION MIP images did not show a significant difference in sensitivity for the detection of small BM compared with native images.
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Affiliation(s)
- Marco Parillo
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
- Research Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Rome, Italy
| | - Daniele Vertulli
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
- Research Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Rome, Italy
| | - Federica Vaccarino
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
- Research Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Rome, Italy
| | - Carlo Augusto Mallio
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
- Research Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Rome, Italy
| | - Bruno Beomonte Zobel
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
- Research Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Rome, Italy
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Kızıloğlu HA, Beyhan M, Gökçe E. Evaluation of respiratory bronchiolitis nodules with maximum intensity projection images. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230297. [PMID: 37971118 PMCID: PMC10645165 DOI: 10.1590/1806-9282.20230297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/26/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Respiratory bronchiolitis is a disease associated with heavy smoking. Computed tomography in this disease often shows symmetrical and bilaterally ill-defined circumscribed centriacinar micronodular involvement in the upper-middle lobes. The maximum intensity projection method is a kind of image processing method and provides a better evaluation of nodules and vascular structures. Our study aimed to show whether maximum intensity projection images increase the diagnostic accuracy in the detection of micronodules in respiratory bronchiolitis. METHODS Two radiologists with different experiences (first reader: 10-year radiologist with cardiothoracic radiology experience and second reader: nonspecific radiologist with 2 years of experience) reviewed images of patients whose respiratory bronchiolitis diagnosis was supported by clinical findings. The evaluation was done independently of each other. Both conventional computed tomography images and maximum intensity projection images of the same patients were examined. The detection rates on conventional computed tomography and maximum intensity projection images were then compared. RESULTS A total of 53 patients were evaluated, of whom 48 were men and 5 were women. The first reader detected centriacinar nodules in 42 (79.2%) patients on conventional computed tomography and centriacinar nodules in all 53 (100%) patients on maximum intensity projection images. The second reader detected centriacinar nodules in 12 (22.6%) patients on conventional computed tomography images and in 48 (90.6%) patients on maximum intensity projection images. For the less experienced reader, the detection rate of micronodules in respiratory bronchiolitis in maximum intensity projection images increased statistically significantly (p<0.001). CONCLUSION Maximum intensity projection images in respiratory bronchiolitis increase the detectability of micronodules independently of the experience of the radiologist.
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Affiliation(s)
- Hüseyin Alper Kızıloğlu
- Tokat Gaziosmanpaşa University, Faculty of Medicine, Department of Radiology – Tokat, Turkey
| | - Murat Beyhan
- Tokat Gaziosmanpaşa University, Faculty of Medicine, Department of Radiology – Tokat, Turkey
| | - Erkan Gökçe
- Tokat Gaziosmanpaşa University, Faculty of Medicine, Department of Radiology – Tokat, Turkey
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Salfity HVN, Tong BC, Kocher MR, Tailor TD. Historical Perspective on Lung Cancer Screening. Thorac Surg Clin 2023; 33:309-321. [PMID: 37806734 DOI: 10.1016/j.thorsurg.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Lung cancer represents a large burden on society with a staggering incidence and mortality rate that has steadily increased until recently. The impetus to design an effective screening program for the deadliest cancer in the United States and worldwide began in 1950. It has taken more than 50 years of numerous clinical trials and continued persistence to arrive at the development of modern-day screening program. As the program continues to grow, it is important for clinicians to understand its evolution, track outcomes, and continually assess the impact and bias of screening on the medical, social, and economic systems.
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Affiliation(s)
- Hai V N Salfity
- Division of Thoracic Surgery, Department of Surgery, University of Cincinnati School of Medicine, 231 Albert Sabin Way Suite 2472, Cincinnati, OH 45267, USA.
| | - Betty C Tong
- Division of Thoracic Surgery, Department of Surgery, Duke University School of Medicine, Box 3531 DUMC, Durham, NC 27710, USA
| | - Madison R Kocher
- Division of Cardiothoracic Imaging, Department of Radiology, Duke University School of Medicine, Box 3808 DUMC, Durham, NC 27710, USA
| | - Tina D Tailor
- Division of Cardiothoracic Imaging, Department of Radiology, Duke University School of Medicine, Box 3808 DUMC, Durham, NC 27710, USA
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4
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Godoy MCB, Lago EAD, Pria HRFD, Shroff GS, Strange CD, Truong MT. Pearls and Pitfalls in Lung Cancer CT Screening. Semin Ultrasound CT MR 2022; 43:246-256. [PMID: 35688535 DOI: 10.1053/j.sult.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Annual LDCT lung cancer screening is recommended by the United States Preventive Services Task Force (USPSTF) for high-risk population based on the results from the National Lung Cancer Screening Trial (NLST) that showed a significant (20%) reduction in lung cancer-specific mortality rate with the use of annual low-dose computed tomography (LDCT) screening. More recently, the benefits of lung cancer screening were confirmed by the Dutch- Belgian NELSON trial in Europe. With the implementation of lung screening in large scale, knowledge of the limitations related to false positive, false negative and other potential pitfalls is essential to avoid misdiagnosis. This review outlines the most common potential pitfalls in the characterization of screen-detected lung nodules that include artifacts in LDCT, benign nodules that mimic lung cancer, and causes of false negative evaluations of lung cancer with LDCT and PET/CT studies. Awareness of the spectrum of potential pitfalls in pulmonary nodule detection and characterization, including equivocal or atypical presentations, is important for avoiding misinterpretation that can alter patient management.
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Affiliation(s)
- Myrna C B Godoy
- Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Eduardo A Dal Lago
- Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Girish S Shroff
- Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Chad D Strange
- Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Mylene T Truong
- Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
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5
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Cui X, Zheng S, Heuvelmans MA, Du Y, Sidorenkov G, Fan S, Li Y, Xie Y, Zhu Z, Dorrius MD, Zhao Y, Veldhuis RNJ, de Bock GH, Oudkerk M, van Ooijen PMA, Vliegenthart R, Ye Z. Performance of a deep learning-based lung nodule detection system as an alternative reader in a Chinese lung cancer screening program. Eur J Radiol 2021; 146:110068. [PMID: 34871936 DOI: 10.1016/j.ejrad.2021.110068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 10/03/2021] [Accepted: 11/22/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate the performance of a deep learning-based computer-aided detection (DL-CAD) system in a Chinese low-dose CT (LDCT) lung cancer screening program. MATERIALS AND METHODS One-hundred-and-eighty individuals with a lung nodule on their baseline LDCT lung cancer screening scan were randomly mixed with screenees without nodules in a 1:1 ratio (total: 360 individuals). All scans were assessed by double reading and subsequently processed by an academic DL-CAD system. The findings of double reading and the DL-CAD system were then evaluated by two senior radiologists to derive the reference standard. The detection performance was evaluated by the Free Response Operating Characteristic curve, sensitivity and false-positive (FP) rate. The senior radiologists categorized nodules according to nodule diameter, type (solid, part-solid, non-solid) and Lung-RADS. RESULTS The reference standard consisted of 262 nodules ≥ 4 mm in 196 individuals; 359 findings were considered false positives. The DL-CAD system achieved a sensitivity of 90.1% with 1.0 FP/scan for detection of lung nodules regardless of size or type, whereas double reading had a sensitivity of 76.0% with 0.04 FP/scan (P = 0.001). The sensitivity for detection of nodules ≥ 4 - ≤ 6 mm was significantly higher with DL-CAD than with double reading (86.3% vs. 58.9% respectively; P = 0.001). Sixty-three nodules were only identified by the DL-CAD system, and 27 nodules only found by double reading. The DL-CAD system reached similar performance compared to double reading in Lung-RADS 3 (94.3% vs. 90.0%, P = 0.549) and Lung-RADS 4 nodules (100.0% vs. 97.0%, P = 1.000), but showed a higher sensitivity in Lung-RADS 2 (86.2% vs. 65.4%, P < 0.001). CONCLUSIONS The DL-CAD system can accurately detect pulmonary nodules on LDCT, with an acceptable false-positive rate of 1 nodule per scan and has higher detection performance than double reading. This DL-CAD system may assist radiologists in nodule detection in LDCT lung cancer screening.
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Affiliation(s)
- Xiaonan Cui
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre of Cancer, Key Laboratory of Cancer Prevention and Therapy, Department of Radiology, Tianjin, People's Republic of China; University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands
| | - Sunyi Zheng
- Westlake University, Artificial Intelligence and Biomedical Image Analysis Lab, School of Engineering, Hangzhou, People's Republic of China; Institute of Advanced Technology, Westlake Institute for Advanced Study, Hangzhou, People's Republic of China; University of Groningen, University Medical Center Groningen, Department of Radiation Oncology, Groningen, the Netherlands
| | - Marjolein A Heuvelmans
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - Yihui Du
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - Grigory Sidorenkov
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - Shuxuan Fan
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre of Cancer, Key Laboratory of Cancer Prevention and Therapy, Department of Radiology, Tianjin, People's Republic of China
| | - Yanju Li
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre of Cancer, Key Laboratory of Cancer Prevention and Therapy, Department of Radiology, Tianjin, People's Republic of China
| | - Yongsheng Xie
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre of Cancer, Key Laboratory of Cancer Prevention and Therapy, Department of Radiology, Tianjin, People's Republic of China
| | - Zhongyuan Zhu
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre of Cancer, Key Laboratory of Cancer Prevention and Therapy, Department of Radiology, Tianjin, People's Republic of China
| | - Monique D Dorrius
- University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands
| | - Yingru Zhao
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre of Cancer, Key Laboratory of Cancer Prevention and Therapy, Department of Radiology, Tianjin, People's Republic of China
| | - Raymond N J Veldhuis
- University of Twente, Faculty of Electrical Engineering Mathematics and Computer Science, the Netherlands
| | - Geertruida H de Bock
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - Matthijs Oudkerk
- University of Groningen, Faculty of Medical Sciences, the Netherlands
| | - Peter M A van Ooijen
- University of Groningen, University Medical Center Groningen, Department of Radiation Oncology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Machine Learning Lab, Data Science Center in Health, Groningen, the Netherlands
| | - Rozemarijn Vliegenthart
- University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands
| | - Zhaoxiang Ye
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre of Cancer, Key Laboratory of Cancer Prevention and Therapy, Department of Radiology, Tianjin, People's Republic of China.
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Couraud S, Ferretti G, Milleron B, Cortot A, Girard N, Gounant V, Laurent F, Leleu O, Quoix E, Revel MP, Wislez M, Westeel V, Zalcman G, Scherpereel A, Khalil A. [Recommendations of French specialists on screening for lung cancer]. Rev Mal Respir 2021; 38:310-325. [PMID: 33637394 DOI: 10.1016/j.rmr.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 01/25/2021] [Indexed: 12/17/2022]
Affiliation(s)
- S Couraud
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, hospices civils de Lyon, hôpital Lyon Sud, Pierre-Bénite, France; Intergroupe francophone de cancérologie thoracique, Paris, France.
| | - G Ferretti
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de radiologie diagnostique et interventionnel, CHU de Grenoble-Alpes, Grenoble, France
| | - B Milleron
- Intergroupe francophone de cancérologie thoracique, Paris, France
| | - A Cortot
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie et oncologie thoracique, CHU de Lille, Lille, France
| | - N Girard
- Intergroupe francophone de cancérologie thoracique, Paris, France; Unité d'oncologie thoracique, institut Curie, Paris, France
| | - V Gounant
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service d'oncologie thoracique, groupe hospitalier Bichat-Claude-Bernard, AP-HP, Paris, France
| | - F Laurent
- Service de radiologie, CHU de Bordeaux, Pessac, France
| | - O Leleu
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie, centre hospitalier Abbeville, Abbeville, France
| | - E Quoix
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie, CHRU Strasbourg, Strasbourg, France
| | - M-P Revel
- Service de radiologie, hôpital Cochin, Paris, France
| | - M Wislez
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service d'oncologie thoracique, hôpital Cochin, Paris, France
| | - V Westeel
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie et cancérologie thoracique, CHU de Besançon, Besançon, France
| | - G Zalcman
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service d'oncologie thoracique, groupe hospitalier Bichat-Claude-Bernard, AP-HP, Paris, France
| | - A Scherpereel
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie et oncologie thoracique, CHU de Lille, Lille, France
| | - A Khalil
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de radiologie, groupe hospitalier Bichat-Claude-Bernard, AP-HP, Paris, France
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7
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Intergroupe francophone de cancérologie thoracique, Société de pneumologie de langue française, and Société d'imagerie thoracique statement paper on lung cancer screening. Diagn Interv Imaging 2021; 102:199-211. [PMID: 33648872 DOI: 10.1016/j.diii.2021.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 01/21/2021] [Accepted: 01/29/2021] [Indexed: 12/17/2022]
Abstract
Following the American National Lung Screening Trial results in 2011 a consortium of French experts met to edit a statement. Recent results of other randomized trials gave the opportunity for our group to meet again in order to edit updated guidelines. After literature review, we provide here a new update on lung cancer screening in France. Notably, in accordance with all international guidelines, the experts renew their recommendation in favor of individual screening for lung cancer in France as per the conditions laid out in this document. In addition, the experts recommend the very rapid organization and funding of prospective studies, which, if conclusive, will enable the deployment of lung cancer screening organized at the national level.
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8
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Zheng S, Cui X, Vonder M, Veldhuis RNJ, Ye Z, Vliegenthart R, Oudkerk M, van Ooijen PMA. Deep learning-based pulmonary nodule detection: Effect of slab thickness in maximum intensity projections at the nodule candidate detection stage. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 196:105620. [PMID: 32615493 DOI: 10.1016/j.cmpb.2020.105620] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE To investigate the effect of the slab thickness in maximum intensity projections (MIPs) on the candidate detection performance of a deep learning-based computer-aided detection (DL-CAD) system for pulmonary nodule detection in CT scans. METHODS The public LUNA16 dataset includes 888 CT scans with 1186 nodules annotated by four radiologists. From those scans, MIP images were reconstructed with slab thicknesses of 5 to 50 mm (at 5 mm intervals) and 3 to 13 mm (at 2 mm intervals). The architecture in the nodule candidate detection part of the DL-CAD system was trained separately using MIP images with various slab thicknesses. Based on ten-fold cross-validation, the sensitivity and the F2 score were determined to evaluate the performance of using each slab thickness at the nodule candidate detection stage. The free-response receiver operating characteristic (FROC) curve was used to assess the performance of the whole DL-CAD system that took the results combined from 16 MIP slab thickness settings. RESULTS At the nodule candidate detection stage, the combination of results from 16 MIP slab thickness settings showed a high sensitivity of 98.0% with 46 false positives (FPs) per scan. Regarding a single MIP slab thickness of 10 mm, the highest sensitivity of 90.0% with 8 FPs/scan was reached before false positive reduction. The sensitivity increased (82.8% to 90.0%) for slab thickness of 1 to 10 mm and decreased (88.7% to 76.6%) for slab thickness of 15-50 mm. The number of FPs was decreasing with increasing slab thickness, but was stable at 5 FPs/scan at a slab thickness of 30 mm or more. After false positive reduction, the DL-CAD system, utilizing 16 MIP slab thickness settings, had the sensitivity of 94.4% with 1 FP/scan. CONCLUSIONS The utilization of multi-MIP images could improve the performance at the nodule candidate detection stage, even for the whole DL-CAD system. For a single slab thickness of 10 mm, the highest sensitivity for pulmonary nodule detection was reached at the nodule candidate detection stage, similar to the slab thickness usually applied by radiologists.
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Affiliation(s)
- Sunyi Zheng
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Xiaonan Cui
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre of Cancer, Tianjin, China
| | - Marleen Vonder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Zhaoxiang Ye
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre of Cancer, Tianjin, China
| | - Rozemarijn Vliegenthart
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Peter M A van Ooijen
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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9
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Hainc N, Federau C, Tyndall A, Mittermeier A, Bink A, Stippich C, Schubert T. Evaluation of the clinical utility of maximum intensity projections of
3D contrast‐enhanced
,
T1
‐weighted imaging for the detection of brain metastases. Cancer Rep (Hoboken) 2020; 3:e1277. [DOI: 10.1002/cnr2.1277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/09/2020] [Accepted: 07/08/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Nicolin Hainc
- Department of Medical Imaging, Division of Neuroradiology Toronto Western Hospital Toronto Ontario Canada
- Department of Neuroradiology, Clinical Neuroscience Center University Hospital Zurich, University of Zurich Zurich Switzerland
| | - Christian Federau
- Division of Diagnostic and Interventional Neuroradiology, Department of Radiology University Hospital Basel, University of Basel Basel Switzerland
- Institute for Biomedical Engineering Swiss Federal Institute of Technology Zurich Switzerland
| | - Anthony Tyndall
- Department of Neuroradiology, Clinical Neuroscience Center University Hospital Zurich, University of Zurich Zurich Switzerland
- Division of Diagnostic and Interventional Neuroradiology, Department of Radiology University Hospital Basel, University of Basel Basel Switzerland
| | - Andreas Mittermeier
- Department of Medical Imaging The Hospital for Sick Children, University of Toronto Toronto Canada
- Department of Radiology Ludwig‐Maximilians‐University Hospital Munich Munich Germany
| | - Andrea Bink
- Department of Neuroradiology, Clinical Neuroscience Center University Hospital Zurich, University of Zurich Zurich Switzerland
- Division of Diagnostic and Interventional Neuroradiology, Department of Radiology University Hospital Basel, University of Basel Basel Switzerland
| | - Christoph Stippich
- Department of Neuroradiology, Clinical Neuroscience Center University Hospital Zurich, University of Zurich Zurich Switzerland
- Division of Diagnostic and Interventional Neuroradiology, Department of Radiology University Hospital Basel, University of Basel Basel Switzerland
| | - Tilman Schubert
- Department of Neuroradiology, Clinical Neuroscience Center University Hospital Zurich, University of Zurich Zurich Switzerland
- Division of Diagnostic and Interventional Neuroradiology, Department of Radiology University Hospital Basel, University of Basel Basel Switzerland
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Liew CJY, Leong LCH, Teo LLS, Ong CC, Cheah FK, Tham WP, Salahudeen HMM, Lee CH, Kaw GJL, Tee AKH, Tsou IYY, Tay KH, Quah R, Tan BP, Chou H, Tan D, Poh ACC, Tan AGS. A practical and adaptive approach to lung cancer screening: a review of international evidence and position on CT lung cancer screening in the Singaporean population by the College of Radiologists Singapore. Singapore Med J 2020; 60:554-559. [PMID: 31781779 DOI: 10.11622/smedj.2019145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Lung cancer is the leading cause of cancer-related death around the world, being the top cause of cancer-related deaths among men and the second most common cause of cancer-related deaths among women in Singapore. Currently, no screening programme for lung cancer exists in Singapore. Since there is mounting evidence indicating a different epidemiology of lung cancer in Asian countries, including Singapore, compared to the rest of the world, a unique and adaptive approach must be taken for a screening programme to be successful at reducing mortality while maintaining cost-effectiveness and a favourable risk-benefit ratio. This review article promotes the use of low-dose computed tomography of the chest and explores the radiological challenges and future directions.
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Affiliation(s)
| | | | - Lynette Li San Teo
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | - Ching Ching Ong
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | - Foong Koon Cheah
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - Wei Ping Tham
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | | | - Chau Hung Lee
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
| | | | - Augustine Kim Huat Tee
- Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore
| | - Ian Yu Yan Tsou
- Department of Diagnostic Radiology, Mount Elizabeth Hospital, Singapore
| | - Kiang Hiong Tay
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - Raymond Quah
- Department of Diagnostic Radiology, Farrer Park Hospital, Singapore
| | - Bien Peng Tan
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
| | - Hong Chou
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore
| | - Daniel Tan
- Department of Diagnostic Radiology Oncology, Farrer Park Hospital, Singapore
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Xu YM, Zhang T, Xu H, Qi L, Zhang W, Zhang YD, Gao DS, Yuan M, Yu TF. Deep Learning in CT Images: Automated Pulmonary Nodule Detection for Subsequent Management Using Convolutional Neural Network. Cancer Manag Res 2020; 12:2979-2992. [PMID: 32425607 PMCID: PMC7196793 DOI: 10.2147/cmar.s239927] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/05/2020] [Indexed: 12/26/2022] Open
Abstract
PURPOSE The purpose of this study is to compare the detection performance of the 3-dimensional convolutional neural network (3D CNN)-based computer-aided detection (CAD) models with radiologists of different levels of experience in detecting pulmonary nodules on thin-section computed tomography (CT). PATIENTS AND METHODS We retrospectively reviewed 1109 consecutive patients who underwent follow-up thin-section CT at our institution. The 3D CNN model for nodule detection was re-trained and complemented by expert augmentation. The annotations of a consensus panel consisting of two expert radiologists determined the ground truth. The detection performance of the re-trained CAD model and three other radiologists at different levels of experience were tested using a free-response receiver operating characteristic (FROC) analysis in the test group. RESULTS The detection performance of the re-trained CAD model was significantly better than that of the pre-trained network (sensitivity: 93.09% vs 38.44%). The re-trained CAD model had a significantly better detection performance than radiologists (average sensitivity: 93.09% vs 50.22%), without significantly increasing the number of false positives per scan (1.64 vs 0.68). In the training set, 922 nodules less than 3 mm in size in 211 patients at high risk were recommended for follow-up CT according to the Fleischner Society Guidelines. Fifteen of 101 solid nodules were confirmed to be lung cancer. CONCLUSION The re-trained 3D CNN-based CAD model, complemented by expert augmentation, was an accurate and efficient tool in identifying incidental pulmonary nodules for subsequent management.
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Affiliation(s)
- Yi-Ming Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Teng Zhang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Hai Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Liang Qi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Wei Zhang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Yu-Dong Zhang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Da-Shan Gao
- 12sigma Technologies, San Diego, California, USA
| | - Mei Yuan
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Tong-Fu Yu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
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Zheng S, Guo J, Cui X, Veldhuis RNJ, Oudkerk M, van Ooijen PMA. Automatic Pulmonary Nodule Detection in CT Scans Using Convolutional Neural Networks Based on Maximum Intensity Projection. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:797-805. [PMID: 31425026 DOI: 10.1109/tmi.2019.2935553] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Accurate pulmonary nodule detection is a crucial step in lung cancer screening. Computer-aided detection (CAD) systems are not routinely used by radiologists for pulmonary nodule detection in clinical practice despite their potential benefits. Maximum intensity projection (MIP) images improve the detection of pulmonary nodules in radiological evaluation with computed tomography (CT) scans. Inspired by the clinical methodology of radiologists, we aim to explore the feasibility of applying MIP images to improve the effectiveness of automatic lung nodule detection using convolutional neural networks (CNNs). We propose a CNN-based approach that takes MIP images of different slab thicknesses (5 mm, 10 mm, 15 mm) and 1 mm axial section slices as input. Such an approach augments the two-dimensional (2-D) CT slice images with more representative spatial information that helps discriminate nodules from vessels through their morphologies. Our proposed method achieves sensitivity of 92.7% with 1 false positive per scan and sensitivity of 94.2% with 2 false positives per scan for lung nodule detection on 888 scans in the LIDC-IDRI dataset. The use of thick MIP images helps the detection of small pulmonary nodules (3 mm-10 mm) and results in fewer false positives. Experimental results show that utilizing MIP images can increase the sensitivity and lower the number of false positives, which demonstrates the effectiveness and significance of the proposed MIP-based CNNs framework for automatic pulmonary nodule detection in CT scans. The proposed method also shows the potential that CNNs could gain benefits for nodule detection by combining the clinical procedure.
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13
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Wood DE, Kazerooni EA, Baum SL, Eapen GA, Ettinger DS, Hou L, Jackman DM, Klippenstein D, Kumar R, Lackner RP, Leard LE, Lennes IT, Leung ANC, Makani SS, Massion PP, Mazzone P, Merritt RE, Meyers BF, Midthun DE, Pipavath S, Pratt C, Reddy C, Reid ME, Rotter AJ, Sachs PB, Schabath MB, Schiebler ML, Tong BC, Travis WD, Wei B, Yang SC, Gregory KM, Hughes M. Lung Cancer Screening, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2019; 16:412-441. [PMID: 29632061 DOI: 10.6004/jnccn.2018.0020] [Citation(s) in RCA: 370] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Lung cancer is the leading cause of cancer-related mortality in the United States and worldwide. Early detection of lung cancer is an important opportunity for decreasing mortality. Data support using low-dose computed tomography (LDCT) of the chest to screen select patients who are at high risk for lung cancer. Lung screening is covered under the Affordable Care Act for individuals with high-risk factors. The Centers for Medicare & Medicaid Services (CMS) covers annual screening LDCT for appropriate Medicare beneficiaries at high risk for lung cancer if they also receive counseling and participate in shared decision-making before screening. The complete version of the NCCN Guidelines for Lung Cancer Screening provides recommendations for initial and subsequent LDCT screening and provides more detail about LDCT screening. This manuscript focuses on identifying patients at high risk for lung cancer who are candidates for LDCT of the chest and on evaluating initial screening findings.
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Effect of Slab Thickness on the Detection of Pulmonary Nodules by Use of CT Maximum and Minimum Intensity Projection. AJR Am J Roentgenol 2019; 213:562-567. [PMID: 31063429 DOI: 10.2214/ajr.19.21325] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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15
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Ludwig M, Chipon E, Cohen J, Reymond E, Medici M, Cole A, Moreau Gaudry A, Ferretti G. Detection of pulmonary nodules: a clinical study protocol to compare ultra-low dose chest CT and standard low-dose CT using ASIR-V. BMJ Open 2019; 9:e025661. [PMID: 31420379 PMCID: PMC6701577 DOI: 10.1136/bmjopen-2018-025661] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Lung cancer screening in individuals at risk has been recommended by various scientific institutions. One of the main concerns for CT screening is repeated radiation exposure, with the risk of inducing malignancies in healthy individuals. Therefore, lowering the radiation dose is one of the main objectives for radiologists. The aim of this study is to demonstrate that an ultra-low dose (ULD) chest CT protocol, using recently introduced hybrid iterative reconstruction (ASiR-V, GE medical Healthcare, Milwaukee, Wisconsin, USA), is as performant as a standard 'low dose' (LD) CT to detect non-calcified lung nodules ≥4 mm. METHODS AND ANALYSIS The total number of patients to include is 150. Those are referred for non-enhanced chest CT for detection or follow-up of lung nodule and will undergo an additional unenhanced ULD CT acquisition, the dose of which is on average 10 times lower than the conventional LD acquisition. Total dose of the entire exam (LD+ULD) is lower than the French diagnostic reference level for a chest CT (6.65 millisievert). ULD CT images will be reconstructed with 50% and 100% ASiR-V and LD CT with 50%. The three sets of images will be read in random order by two pair of radiologists, in a blind test, where patient identification and study outcomes are concealed. Detection rate (sensitivity) is the primary outcome. Secondary outcomes will include concordance of nodule characteristics; interobserver reproducibility; influence of subjects' characteristics, nodule location and nodule size; and concordance of emphysema, coronary calcifications evaluated by visual scoring and bronchial alterations between LD and ULD CT. In case of discordance, a third radiologist will arbitrate. ETHICS AND DISSEMINATION The study was approved by the relevant ethical committee. Each study participant will sign an informed consent form. TRIAL REGISTRATION NUMBER NCT03305978; Pre-results.
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Affiliation(s)
- Marie Ludwig
- Service de radiologie et imagerie médicale, pôle imagerie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Faculte de Medecine, Universite Grenoble Alpes, La Tronche, France
| | - Emilie Chipon
- CIC 1406, INSERM, Grenoble, France
- Pôle recherche, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Julien Cohen
- Service de radiologie et imagerie médicale, pôle imagerie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Faculte de Medecine, Universite Grenoble Alpes, La Tronche, France
| | - Emilie Reymond
- Service de radiologie et imagerie médicale, pôle imagerie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Maud Medici
- CIC 1406, INSERM, Grenoble, France
- Pôle recherche, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Anthony Cole
- Service de radiologie et imagerie médicale, pôle imagerie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Faculte de Medecine, Universite Grenoble Alpes, La Tronche, France
| | - Alexandre Moreau Gaudry
- CIC 1406, INSERM, Grenoble, France
- Pôle recherche, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Gilbert Ferretti
- Service de radiologie et imagerie médicale, pôle imagerie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Faculte de Medecine, Universite Grenoble Alpes, La Tronche, France
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McNulty W, Baldwin D. Management of pulmonary nodules. BJR Open 2019; 1:20180051. [PMID: 33178935 PMCID: PMC7592490 DOI: 10.1259/bjro.20180051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/17/2019] [Accepted: 03/19/2019] [Indexed: 11/05/2022] Open
Abstract
Pulmonary nodules are frequently detected during clinical practice and require a structured approach in their management in order to identify early lung cancers and avoid harm from over investigation. The article reviews the 2015 British Thoracic Society guidelines for the management of pulmonary nodules and the evidence behind them.
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Affiliation(s)
- William McNulty
- King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK
| | - David Baldwin
- Nottingham University Hospitals NHS Trust, City Campus, Hucknall Road, Nottingham, England
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Liu GT, Ryan E, Gustafson E, VanPelt MD, Raspovic KM, Lalli T, Wukich DK, Xi Y, Chhabra A. Three-Dimensional Computed Tomographic Characterization of Normal Anatomic Morphology and Variations of the Distal Tibiofibular Syndesmosis. J Foot Ankle Surg 2019; 57:1130-1136. [PMID: 30197255 DOI: 10.1053/j.jfas.2018.05.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Indexed: 02/03/2023]
Abstract
Malreduction of distal tibiofibular syndesmosis (DTFS) leads to poor functional outcomes after ankle fracture surgery. Difficulty achieving anatomic alignment of the syndesmosis is due to variable morphology of the fibular incisura of the tibia and a paucity of literature regarding its morphologic characteristics. We surveyed 775 consecutive ankle computed tomography (CT) scans performed from June 2008 to December 2011, and 203 (26.2%) were included for evaluation. Two observers performed quantitative measurements and qualitative evaluated fibular incisura morphology. Tang ratios for fibular rotation, anterior and posterior tibiofibular distances, fibular incisura depth, and subjective morphologies on CT were assessed using conventional multiplanar reconstruction (MPR) and maximum intensity projections (MIPs). On conventional CT, the mean Tang ratio was 0.97 ± 0.06; the mean anterior tibiofibular distance was 2.17 ± 0.87 mm; the mean posterior tibiofibular distance was 3.52 ± 0.94 mm; and the mean depth of fibular incisura was 3.29 ± 1.19 mm. Five morphologic variations of the fibular incisura were identified: crescentic, trapezoid, flat, chevron, and widow's peak. The most common fibular incisura morphology was crescentic (61.3%), followed by trapezoid shape (25.1%); the least common morphology was flat (3.1%). Interobserver variability with intraclass correlation coefficient (ICC) was slightly higher for all quantitative measures on MPR (ICC = 0.72 to .81) versus MIP (ICC = 0.64 to 0.75). ICC for incisura shape and depth assessments was poor on both modalities (0.13 to 0.38). This comprehensive CT study reports on quantitative and qualitative descriptive measures to evaluate fibular incisura morphologies and fibular orientation. It also defines the frequency of DTFS measures and the interobserver performance on 2 CT evaluation methods.
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Affiliation(s)
- George T Liu
- Associate Professor, Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
| | - Easton Ryan
- Medical Student, University of Texas Southwestern Medical School, Dallas, TX
| | - Eric Gustafson
- Medical Student, University of Texas Southwestern Medical School, Dallas, TX
| | - Michael D VanPelt
- Associate Professor, Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Katherine M Raspovic
- Assistant Professor, Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Trapper Lalli
- Assistant Professor, Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Dane K Wukich
- Professor and Chairman, Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Yin Xi
- Associate Professor, Radiology, and Chief, Division of Musculoskeletal Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Avneesh Chhabra
- Associate Professor, Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX; Assistant Professor, Radiology, University of Texas Southwestern Medical Center, Dallas, TX
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18
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Yoon BC, Saad AF, Rezaii P, Wintermark M, Zaharchuk G, Iv M. Evaluation of Thick-Slab Overlapping MIP Images of Contrast-Enhanced 3D T1-Weighted CUBE for Detection of Intracranial Metastases: A Pilot Study for Comparison of Lesion Detection, Interpretation Time, and Sensitivity with Nonoverlapping CUBE MIP, CUBE, and Inversion-Recovery-Prepared Fast-Spoiled Gradient Recalled Brain Volume. AJNR Am J Neuroradiol 2018; 39:1635-1642. [PMID: 30093483 DOI: 10.3174/ajnr.a5747] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 06/16/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Early and accurate identification of cerebral metastases is important for prognostication and treatment planning although this process is often time consuming and labor intensive, especially with the hundreds of images associated with 3D volumetric imaging. This study aimed to evaluate the benefits of thick-slab overlapping MIPs constructed from contrast-enhanced T1-weighted CUBE (overlapping CUBE MIP) for the detection of brain metastases in comparison with traditional CUBE and inversion-recovery prepared fast-spoiled gradient recalled brain volume (IR-FSPGR-BRAVO) and nonoverlapping CUBE MIP. MATERIALS AND METHODS A retrospective review of 48 patients with cerebral metastases was performed at our institution from June 2016 to October 2017. Brain MRIs, which were acquired on multiple 3T scanners, included gadolinium-enhanced T1-weighted IR-FSPGR-BRAVO and CUBE, with subsequent generation of nonoverlapping CUBE MIP and overlapping CUBE MIP. Two blinded radiologists identified the total number and location of metastases on each image type. The Cohen κ was used to determine interrater agreement. Sensitivity, interpretation time, and lesion contrast-to-noise ratio were assessed. RESULTS Interrater agreement for identification of metastases was fair-to-moderate for all image types (κ = 0.222-0.598). The total number of metastases identified was not significantly different across the image types. Interpretation time for CUBE MIPs was significantly shorter than for CUBE and IR-FSPGR-BRAVO, saving at least 50 seconds per case on average (P < .001). The mean lesion contrast-to-noise ratio for both CUBE MIPs was higher than for IR-FSPGR-BRAVO. The mean contrast-to-noise ratio for small lesions (<4 mm) was lower for nonoverlapping CUBE MIP (1.55) than for overlapping CUBE MIP (2.35). For both readers, the sensitivity for lesion detection was high for all image types but highest for overlapping CUBE MIP and CUBE (0.93-0.97). CONCLUSIONS This study suggests that the use of overlapping CUBE MIP or nonoverlapping CUBE MIP for the detection of brain metastases can reduce interpretation time without sacrificing sensitivity, though the contrast-to-noise ratio of lesions is highest for overlapping CUBE MIP.
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Affiliation(s)
- B C Yoon
- From the Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University, Stanford, California
| | - A F Saad
- From the Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University, Stanford, California
| | - P Rezaii
- From the Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University, Stanford, California
| | - M Wintermark
- From the Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University, Stanford, California
| | - G Zaharchuk
- From the Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University, Stanford, California
| | - M Iv
- From the Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University, Stanford, California.
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Vlahos I, Stefanidis K, Sheard S, Nair A, Sayer C, Moser J. Lung cancer screening: nodule identification and characterization. Transl Lung Cancer Res 2018; 7:288-303. [PMID: 30050767 DOI: 10.21037/tlcr.2018.05.02] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The accurate identification and characterization of small pulmonary nodules at low-dose CT is an essential requirement for the implementation of effective lung cancer screening. Individual reader detection performance is influenced by nodule characteristics and technical CT parameters but can be improved by training, the application of CT techniques, and by computer-aided techniques. However, the evaluation of nodule detection in lung cancer screening trials differs from the assessment of individual readers as it incorporates multiple readers, their inter-observer variability, reporting thresholds, and reflects the program accuracy in identifying lung cancer. Understanding detection and interpretation errors in screening trials aids in the implementation of lung cancer screening in clinical practice. Indeed, as CT screening moves to ever lower radiation doses, radiologists must be cognisant of new technical challenges in nodule assessment. Screen detected lung cancers demonstrate distinct morphological features from incidentally or symptomatically detected lung cancers. Hence characterization of screen detected nodules requires an awareness of emerging concepts in early lung cancer appearances and their impact on radiological assessment and malignancy prediction models. Ultimately many nodules remain indeterminate, but further imaging evaluation can be appropriate with judicious utilization of contrast enhanced CT or MRI techniques or functional evaluation by PET-CT.
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Affiliation(s)
- Ioannis Vlahos
- St George's NHS Foundation Hospitals Trust and School of Medicine, London, UK
| | | | | | - Arjun Nair
- Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Charles Sayer
- Brighton and Sussex University Hospitals Trust, Haywards Heath, UK
| | - Joanne Moser
- St George's NHS Foundation Hospitals Trust and School of Medicine, London, UK
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20
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Godoy MCB, Odisio EGLC, Truong MT, de Groot PM, Shroff GS, Erasmus JJ. Pulmonary Nodule Management in Lung Cancer Screening: A Pictorial Review of Lung-RADS Version 1.0. Radiol Clin North Am 2018; 56:353-363. [PMID: 29622071 DOI: 10.1016/j.rcl.2018.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The number of screening-detected lung nodules is expected to increase as low-dose computed tomography screening is implemented nationally. Standardized guidelines for image acquisition, interpretation, and screen-detected nodule workup are essential to ensure a high standard of medical care and that lung cancer screening is implemented safely and cost effectively. In this article, we review the current guidelines for pulmonary nodule management in the lung cancer screening setting.
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Affiliation(s)
- Myrna C B Godoy
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 371, Houston, TX 77030, USA.
| | - Erika G L C Odisio
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 371, Houston, TX 77030, USA
| | - Mylene T Truong
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 371, Houston, TX 77030, USA
| | - Patricia M de Groot
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 371, Houston, TX 77030, USA
| | - Girish S Shroff
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 371, Houston, TX 77030, USA
| | - Jeremy J Erasmus
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 371, Houston, TX 77030, USA
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A comparison of computer-assisted detection (CAD) programs for the identification of colorectal polyps: performance and sensitivity analysis, current limitations and practical tips for radiologists. Clin Radiol 2018; 73:593.e11-593.e18. [PMID: 29602538 DOI: 10.1016/j.crad.2018.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/13/2018] [Indexed: 01/27/2023]
Abstract
AIM To directly compare the accuracy and speed of analysis of two commercially available computer-assisted detection (CAD) programs in detecting colorectal polyps. MATERIALS AND METHOD In this retrospective single-centre study, patients who had colorectal polyps identified on computed tomography colonography (CTC) and subsequent lower gastrointestinal endoscopy, were analysed using two commercially available CAD programs (CAD1 and CAD2). Results were compared against endoscopy to ascertain sensitivity and positive predictive value (PPV) for colorectal polyps. Time taken for CAD analysis was also calculated. RESULTS CAD1 demonstrated a sensitivity of 89.8%, PPV of 17.6% and mean analysis time of 125.8 seconds. CAD2 demonstrated a sensitivity of 75.5%, PPV of 44.0% and mean analysis time of 84.6 seconds. CONCLUSION The sensitivity and PPV for colorectal polyps and CAD analysis times can vary widely between current commercially available CAD programs. There is still room for improvement. Generally, there is a trade-off between sensitivity and PPV, and so further developments should aim to optimise both. Information on these factors should be made routinely available, so that an informed choice on their use can be made. This information could also potentially influence the radiologist's use of CAD results.
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22
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Verhagen MV, Smets AMJB, van Schuppen J, Deurloo EE, Schaefer-Prokop C. The impact of reconstruction techniques on observer performance for the detection and characterization of small pulmonary nodules in chest CT of children under 13 years. Eur J Radiol 2018; 100:142-146. [PMID: 29496073 DOI: 10.1016/j.ejrad.2018.01.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 11/29/2017] [Accepted: 01/15/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare three different reconstruction techniques of CT data for the detection of pulmonary nodules in children under 13 years. Secondly to assess the prevalence of perifissural nodular opacities. MATERIALS AND METHODS The study consisted of chest CTs of 31 children (median age 6.9 years, range 2.1-12.7), of whom 17 had known extra-thoracic malignancies. Four observers assessed three techniques for the presence of nodules: axial 5 mm maximum intensity projections (MIPs) used in conjunction with 1 mm slices (mode A), 1 mm slices alone (mode B) and 3 mm slices (mode C). All modes were available in 3D. Per mode sensitivities were determined above a certain threshold of reader agreement. Confidence level and reader agreement for identification of an opacity as nodule served as surrogate for quality of nodule characterization. RESULTS 103 nodules (median size 2.0 mm) were detected. Mode A yielded the highest interreader agreement (κ 0.336) and a superior sensitivity (71%, p = 0.003) compared to mode B and C (κ 0.218, sensitivity 57% and κ 0.247, sensitivity 56%, respectively). Mode B provided the highest confidence level and interreader agreement with respect to nodule identification (mean 4.3/5, κw 0.508). Double reading improved and evened interreader agreement for all modes (κ 0.450), mode A maintained the highest sensitivity (89.1%, p = 0.05-0.08). A median of 1 intrapulmonary lymph node/patient was seen in children with and without malignancy. CONCLUSION MIP improves the detection of pulmonary nodules in chest CTs of children, but overall interreader agreement is only fair. Double reading represents a powerful tool to increase diagnostic reliability in chest CTs of children with a malignancy. Nodule characterization is best with 1 mm slices. Intrapulmonary lymph nodes occur in children with and without malignancy.
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Affiliation(s)
- Martijn V Verhagen
- Academic Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands.
| | - Anne M J B Smets
- Academic Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands.
| | - Joost van Schuppen
- Academic Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands.
| | - Eline E Deurloo
- Academic Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands.
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Del Ciello A, Franchi P, Contegiacomo A, Cicchetti G, Bonomo L, Larici AR. Missed lung cancer: when, where, and why? Diagn Interv Radiol 2017; 23:118-126. [PMID: 28206951 DOI: 10.5152/dir.2016.16187] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Missed lung cancer is a source of concern among radiologists and an important medicolegal challenge. In 90% of the cases, errors in diagnosis of lung cancer occur on chest radiographs. It may be challenging for radiologists to distinguish a lung lesion from bones, pulmonary vessels, mediastinal structures, and other complex anatomical structures on chest radiographs. Nevertheless, lung cancer can also be overlooked on computed tomography (CT) scans, regardless of the context, either if a clinical or radiologic suspect exists or for other reasons. Awareness of the possible causes of overlooking a pulmonary lesion can give radiologists a chance to reduce the occurrence of this eventuality. Various factors contribute to a misdiagnosis of lung cancer on chest radiographs and on CT, often very similar in nature to each other. Observer error is the most significant one and comprises scanning error, recognition error, decision-making error, and satisfaction of search. Tumor characteristics such as lesion size, conspicuity, and location are also crucial in this context. Even technical aspects can contribute to the probability of skipping lung cancer, including image quality and patient positioning and movement. Albeit it is hard to remove missed lung cancer completely, strategies to reduce observer error and methods to improve technique and automated detection may be valuable in reducing its likelihood.
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Affiliation(s)
- Annemilia Del Ciello
- Institute of Radiology, Department of Radiological Sciences, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, Rome, Italy.
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Bae YJ, Choi BS, Lee KM, Yoon YH, Sunwoo L, Jung C, Kim JH. Efficacy of Maximum Intensity Projection of Contrast-Enhanced 3D Turbo-Spin Echo Imaging with Improved Motion-Sensitized Driven-Equilibrium Preparation in the Detection of Brain Metastases. Korean J Radiol 2017; 18:699-709. [PMID: 28670165 PMCID: PMC5447646 DOI: 10.3348/kjr.2017.18.4.699] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/16/2017] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate the diagnostic benefits of 5-mm maximum intensity projection of improved motion-sensitized driven-equilibrium prepared contrast-enhanced 3D T1-weighted turbo-spin echo imaging (MIP iMSDE-TSE) in the detection of brain metastases. The imaging technique was compared with 1-mm images of iMSDE-TSE (non-MIP iMSDE-TSE), 1-mm contrast-enhanced 3D T1-weighted gradient-echo imaging (non-MIP 3D-GRE), and 5-mm MIP 3D-GRE. Materials and Methods From October 2014 to July 2015, 30 patients with 460 enhancing brain metastases (size > 3 mm, n = 150; size ≤ 3 mm, n = 310) were scanned with non-MIP iMSDE-TSE and non-MIP 3D-GRE. We then performed 5-mm MIP reconstruction of these images. Two independent neuroradiologists reviewed these four sequences. Their diagnostic performance was compared using the following parameters: sensitivity, reading time, and figure of merit (FOM) derived by jackknife alternative free-response receiver operating characteristic analysis. Interobserver agreement was also tested. Results The mean FOM (all lesions, 0.984; lesions ≤ 3 mm, 0.980) and sensitivity ([reader 1: all lesions, 97.3%; lesions ≤ 3 mm, 96.2%], [reader 2: all lesions, 97.0%; lesions ≤ 3 mm, 95.8%]) of MIP iMSDE-TSE was comparable to the mean FOM (0.985, 0.977) and sensitivity ([reader 1: 96.7, 99.0%], [reader 2: 97, 95.3%]) of non-MIP iMSDE-TSE, but they were superior to those of non-MIP and MIP 3D-GREs (all, p < 0.001). The reading time of MIP iMSDE-TSE (reader 1: 47.7 ± 35.9 seconds; reader 2: 44.7 ± 23.6 seconds) was significantly shorter than that of non-MIP iMSDE-TSE (reader 1: 78.8 ± 43.7 seconds, p = 0.01; reader 2: 82.9 ± 39.9 seconds, p < 0.001). Interobserver agreement was excellent (κ > 0.75) for all lesions in both sequences. Conclusion MIP iMSDE-TSE showed high detectability of brain metastases. Its detectability was comparable to that of non-MIP iMSDE-TSE, but it was superior to the detectability of non-MIP/MIP 3D-GREs. With a shorter reading time, the false-positive results of MIP iMSDE-TSE were greater. We suggest that MIP iMSDE-TSE can provide high diagnostic performance and low false-positive rates when combined with 1-mm sequences.
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Affiliation(s)
- Yun Jung Bae
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Byung Se Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Kyung Mi Lee
- Department of Radiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Korea
| | - Yeon Hong Yoon
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Leonard Sunwoo
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Cheolkyu Jung
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
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Burak Özkan M, Tscheuner S, Ozkan E. Diagnostic accuracy of MIP slice modalities for small pulmonary nodules in paediatric oncology patients revisited: What is additional from the paediatric radiologist approach? THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Baldwin D, Callister M. What is the Optimum Screening Strategy for the Early Detection of Lung Cancer. Clin Oncol (R Coll Radiol) 2016; 28:672-681. [DOI: 10.1016/j.clon.2016.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/04/2016] [Accepted: 07/11/2016] [Indexed: 01/26/2023]
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Benzakoun J, Bommart S, Coste J, Chassagnon G, Lederlin M, Boussouar S, Revel MP. Computer-aided diagnosis (CAD) of subsolid nodules: Evaluation of a commercial CAD system. Eur J Radiol 2016; 85:1728-1734. [DOI: 10.1016/j.ejrad.2016.07.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/29/2016] [Accepted: 07/17/2016] [Indexed: 11/25/2022]
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Jensen CT, Vicens-Rodriguez RA, Wagner-Bartak NA, Fox PS, Faria SC, Carrion I, Qayyum A, Tamm EP. Multidetector CT detection of peritoneal metastases: evaluation of sensitivity between standard 2.5 mm axial imaging and maximum-intensity-projection (MIP) reconstructions. ACTA ACUST UNITED AC 2016; 40:2167-72. [PMID: 25666971 DOI: 10.1007/s00261-015-0370-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Our purpose was to evaluate the sensitivity of multidetector CT for the detection of peritoneal metastases between standard 2.5 mm axial imaging and maximum-intensity-projection (MIP) reconstructions. MATERIALS AND METHODS The Institutional Review Board approved this retrospective study and waived the need to obtain patient consent. We retrospectively identified 36 patients with pancreatic adenocarcinoma and peritoneal metastatic disease who underwent a pancreatic protocol CT examination of the abdomen and pelvis between January 2012 and January 2014. Three independent radiologists reviewed a randomized combination of standard axial (2.5 mm reconstructed thickness, 2.5 mm interval) and axial MIP reconstructions (6, 3 mm interval) over two sessions. Each reader recorded metastasis location in PACS. Subsequent consensus review by two radiologists determined the final number and size of metastases. RESULTS The reviewers found 328 peritoneal implants in 36 patients. After accounting for the size, location, and number of lesions as well as multiple readers, a generalized estimating equations model showed that the statistical combination of MIP with standard technique significantly increased the odds of correctly identifying a lesion (OR 2.16; 95% CI 1.86-2.51; p value < 0.0001) compared to standard technique alone. MIP reconstruction as a standalone technique was less sensitive compared to standard technique alone (OR 0.81; 95% CI 0.65-0.99; p value = 0.0468). When compared to standard axial imaging, evaluation via MIP reconstructions resulted in the identification of an additional 50 (15%), 45 (14%), and 55 (17%) lesions by Readers 1-3, respectively. CONCLUSION The axial 6 mm MIP series is complimentary in the CT evaluation of peritoneal metastases. MIP reconstruction evaluation identified a significant number of additional lesions, but is not adequate as a standalone technique for peritoneal cavity assessment.
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Affiliation(s)
- Corey T Jensen
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA.
| | - Rafael A Vicens-Rodriguez
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA
| | - Nicolaus A Wagner-Bartak
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA
| | - Patricia S Fox
- Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Silvana C Faria
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA
| | - Ivan Carrion
- University Hospital Joan XXIII (Tarragona), Avda. Jaume Balmes, XX, X-X, Vilanova i la Geltru Barcelona, 08800, Spain
| | - Aliya Qayyum
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA
| | - Eric P Tamm
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA
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Rampinelli C, Calloni SF, Minotti M, Bellomi M. Spectrum of early lung cancer presentation in low-dose screening CT: a pictorial review. Insights Imaging 2016; 7:449-59. [PMID: 27188380 PMCID: PMC4877352 DOI: 10.1007/s13244-016-0487-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 01/20/2016] [Accepted: 03/18/2016] [Indexed: 12/14/2022] Open
Abstract
The typical presentation of early stage lung cancers on low-dose CT screening are non-calcified pulmonary nodules. However, there is a wide spectrum of unusual focal abnormalities that can be early presentations of lung cancer. These abnormalities include, for example, cancers associated with 'cystic airspaces' or scar-like cancers. The detection of lung cancer with low-dose CT can be affected by the absence of intravenous contrast medium. As a consequence, endobronchial and central lesions can be difficult to recognize, raising the potential for missed cancers. Focal lesions arising within pre-existing lung disease, such as lung fibrosis or apical scars, can also be early lung cancer manifestations and deserve particular consideration as recognition of these lesions may be hindered by the underlying disease. Furthermore, the unpredictable growth rate of lung cancer, which ranges from indolent to aggressive cancers, necessitates attention to the wide spectrum of progression in lung cancer appearance on serial low-dose CT scans. In this pictorial review we discuss the spectrum of early lung cancer presentation in low-dose CT screening, highlighting typical as well as unusual radiological features and the varied growth rates of early lung cancer. Teaching Points • There is a wide spectrum of early presentations of lung cancer on LDCT. • Low radiation dose and the absence of contrast medium injection can affect lung cancer detection. • Lung cancer growth shows various behaviours, ranging from indolent to aggressive cancers. • Familiarity with LDCT technique can improve CT screening effectiveness and avoid missed diagnosis.
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Affiliation(s)
- Cristiano Rampinelli
- Department of Medical Imaging and Radiation Sciences, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy.
| | | | - Marta Minotti
- School of Medicine, University of Milan, Milan, Italy
| | - Massimo Bellomi
- Department of Medical Imaging and Radiation Sciences, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy
- School of Medicine, University of Milan, Milan, Italy
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Utility of MDCT MIP Postprocessing Reconstruction Images in Children With Hereditary Hemorrhagic Telangiectasia. J Comput Assist Tomogr 2016; 40:375-9. [DOI: 10.1097/rct.0000000000000385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Callister MEJ, Baldwin DR, Akram AR, Barnard S, Cane P, Draffan J, Franks K, Gleeson F, Graham R, Malhotra P, Prokop M, Rodger K, Subesinghe M, Waller D, Woolhouse I. British Thoracic Society guidelines for the investigation and management of pulmonary nodules. Thorax 2015; 70 Suppl 2:ii1-ii54. [PMID: 26082159 DOI: 10.1136/thoraxjnl-2015-207168] [Citation(s) in RCA: 545] [Impact Index Per Article: 60.6] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- M E J Callister
- Department of Respiratory Medicine, Leeds Teaching Hospitals, Leeds, UK
| | - D R Baldwin
- Nottingham University Hospitals, Nottingham, UK
| | - A R Akram
- Royal Infirmary of Edinburgh, Edinburgh, UK
| | - S Barnard
- Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle, UK
| | - P Cane
- Department of Histopathology, St Thomas' Hospital, London, UK
| | - J Draffan
- University Hospital of North Tees, Stockton on Tees, UK
| | - K Franks
- Clinical Oncology, St James's Institute of Oncology, Leeds, UK
| | - F Gleeson
- Department of Radiology, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - P Malhotra
- St Helens and Knowsley Teaching Hospitals NHS Trust, UK
| | - M Prokop
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - K Rodger
- Respiratory Medicine, St James's University Hospital, Leeds, UK
| | - M Subesinghe
- Department of Radiology, Churchill Hospital, Oxford, UK
| | - D Waller
- Department of Thoracic Surgery, Glenfield Hospital, Leicester, UK
| | - I Woolhouse
- Department of Respiratory Medicine, University Hospitals of Birmingham, Birmingham, UK
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Harzheim D, Eberhardt R, Hoffmann H, Herth FJF. The Solitary Pulmonary Nodule. Respiration 2015; 90:160-72. [PMID: 26138915 DOI: 10.1159/000430996] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/16/2015] [Indexed: 11/19/2022] Open
Abstract
Due to the high etiological diversity and the potential for malignancy, pulmonary nodules represent a clinical challenge, becoming increasingly frequent as the number of CT examinations rises. The topic gains even more importance as clear evidence for the effectiveness of CT screening was provided by the National Lung Screening Trial (NLST). Yet, the results were tempered by the high false-positive rate and the requirement of performing further diagnostic procedures. The management of those detected solitary pulmonary nodules is currently based on the individuals' risk of developing lung cancer, the pulmonary nodule characteristics and the capability of diagnostic and therapeutic approaches.
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Affiliation(s)
- Dominik Harzheim
- Thoraxklinik am Universitätsklinikum Heidelberg, Heidelberg, Germany
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Godoy MCB, Truong MT, Carter BW, Viswanathan C, de Groot P, Ko JP. Pitfalls in pulmonary nodule characterization. Semin Roentgenol 2015; 50:164-74. [PMID: 26002236 DOI: 10.1053/j.ro.2015.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Myrna C B Godoy
- Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX.
| | - Mylene T Truong
- Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Brett W Carter
- Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Chitra Viswanathan
- Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Patricia de Groot
- Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Jane P Ko
- Department of Radiology, Langone Medical Center, New York University, New York, NY
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ACR-STR practice parameter for the performance and reporting of lung cancer screening thoracic computed tomography (CT): 2014 (Resolution 4). J Thorac Imaging 2015; 29:310-6. [PMID: 24992501 DOI: 10.1097/rti.0000000000000097] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Lung Nodule Detection by Microdose CT Versus Chest Radiography (Standard and Dual-Energy Subtracted). AJR Am J Roentgenol 2015; 204:727-35. [DOI: 10.2214/ajr.14.12921] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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36
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Retrospective Review of Lung Cancers Diagnosed in Annual Rounds of CT Screening. AJR Am J Roentgenol 2014; 203:965-72. [DOI: 10.2214/ajr.13.12115] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Revel MP, Carette MF, Torrent M, Trédaniel J. Diagnosis and standardized report for non-small cell lung cancer. Diagn Interv Imaging 2014; 95:727-38. [PMID: 25022727 DOI: 10.1016/j.diii.2014.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In the assessment of lung cancer, computed tomography guides the use of bronchoscopy and establishes whether local treatment may be appropriate for the NSCLC or whether it is at an advanced stage. Percutaneous biopsy of a lesion suspected to be a metastasis can provide histological confirmation, allowing staging to be carried out at the same time. The initial presentation depends on the staging and histological type, ranging from an isolated nodule or mass to atelectasis or obstructive pneumonia, isolated lymph node disease or isolated pleural effusion to miliary metastasis in tumors showing EGFR mutation. Tumor (T) status depends on tumor size, distance from the carina, and invasion of the chest wall and mediastinal organs. PET-CT is superior to CT in identifying lymph node invasion (N2 for ipsilateral mediastinal disease and N3 for contralateral or supraclavicular disease). As a general rule, all contraindications for surgery should be confirmed via histological examination, with the exception of cerebral metastases.
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Affiliation(s)
- M-P Revel
- Radiology, Cochin Hospital, 27, rue du Fg St-Jacques, 75014 Paris, France.
| | - M-F Carette
- Radiology, Tenon Hospital, 4, rue de la Chine, 75970 Paris cedex 20, France
| | - M Torrent
- Radiology, La Forêt Polyclinic, 4, rue Lagorsse, 77300 Fontainebleau, France
| | - J Trédaniel
- Pneumology, Saint-Joseph Hospital, 1, avenue Claude-Vellefaux, 75010 Paris, France
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Marshall HM, Bowman RV, Yang IA, Fong KM, Berg CD. Screening for lung cancer with low-dose computed tomography: a review of current status. J Thorac Dis 2014; 5 Suppl 5:S524-39. [PMID: 24163745 DOI: 10.3978/j.issn.2072-1439.2013.09.06] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 09/10/2013] [Indexed: 12/19/2022]
Abstract
Screening using low-dose computed tomography (CT) represents an exciting new development in the struggle to improve outcomes for people with lung cancer. Randomised controlled evidence demonstrating a 20% relative lung cancer mortality benefit has led to endorsement of screening by several expert bodies in the US and funding by healthcare providers. Despite this pivotal result, many questions remain regarding technical and logistical aspects of screening, cost-effectiveness and generalizability to other settings. This review discusses the rationale behind screening, the results of on-going trials, potential harms of screening and current knowledge gaps.
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Affiliation(s)
- Henry M Marshall
- Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia; ; University of Queensland Thoracic Research Centre, School of Medicine, The University of Queensland, Brisbane, Australia
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Tekath M, Dutheil F, Bellini R, Roche A, Pereira B, Naughton G, Chamoux A, Michel JL. Comparison of the ultra-low-dose Veo algorithm with the gold standard filtered back projection for detecting pulmonary asbestos-related conditions: a clinical observational study. BMJ Open 2014; 4:e004980. [PMID: 24879827 PMCID: PMC4039784 DOI: 10.1136/bmjopen-2014-004980] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Radiation delivered during CT is a major concern, especially for individuals undergoing repeated screening. We aimed to compare a new ultra-low-dose algorithm called Veo with the gold standard filtered back projection (FBP) for detecting pulmonary asbestos-related conditions. SETTING University Hospital CHU G. Montpied, Clermont-Ferrand, France PARTICIPANTS Asbestos-exposed workers were recruited following referral to screening for asbestos-related conditions. Two acquisitions were performed on a 64-slice CT: the gold standard FBP followed by Veo reconstruction. OUTCOME MEASURES Two radiologists independently assessed asbestos-related abnormalities, pulmonary nodules, radiation doses and image quality (noise). RESULTS We included 27 asbestos-exposed workers (63.3±6.5 years with 11.9±9.7 years of asbestos exposure). We observed 297 pleural plaques in 20 participants (74%). All patients (100%) had pulmonary nodules, totalling 167 nodules. Detection rates did not differ for pleural plaques (Veo 87% vs FBP 97%, NS), pleural thickening (100% for both) and pulmonary nodules (80% for both). Interstitial abnormalities were depicted less frequently with Veo than FBP. False negative and false positive did not exceed 2.7%. Compared with FBP, Veo decreased the radiation dose up to 87% (Veo 0.23±0.07 vs FBP 1.83±0.88 mSv, p<0.001). The objective image noise also decreased with Veo as much as 23% and signal-to-noise ratio increased up to 33%. CONCLUSIONS A low-dose CT with Veo reconstruction substantially reduced radiation. Veo compared favourably with FBP in detecting pleural plaques, pleural thickening and pulmonary nodules. These results should be confirmed on a larger sample size before the use of Veo in clinical routine practice in asbestos-related conditions, especially regarding the low prevalence of interstitial abnormalities in this study. TRIAL REGISTRATION NUMBER NCT01955018.
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Affiliation(s)
- Marielle Tekath
- Department of Radiology, University Hospital CHU G. Montpied, Clermont-Ferrand, France
| | - Frédéric Dutheil
- Department of Occupational Medicine, University Hospital CHU G. Montpied, Clermont-Ferrand, France
- School of Exercise Science, Australian Catholic University, Fitzroy, Victoria, Australia
- Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions EA3533, Blaise Pascal University, Clermont-Ferrand, France
- INRA, UMR 1019, UNH, CRNH Auvergne, Clermont-Ferrand, France
| | - Romain Bellini
- Department of Radiology, Centre Jean Perrin, University Hospital CHU, Clermont-Ferrand, France
| | - Antoine Roche
- Department of Radiology, University Hospital CHU G. Montpied, Clermont-Ferrand, France
| | - Bruno Pereira
- Department of Medical Statistics, University Hospital CHU G. Montpied, Clermont-Ferrand, France
| | - Geraldine Naughton
- School of Exercise Science, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Alain Chamoux
- Department of Occupational Medicine, University Hospital CHU G. Montpied, Clermont-Ferrand, France
| | - Jean-Luc Michel
- Department of Radiology, University Hospital CHU G. Montpied, Clermont-Ferrand, France
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Lederlin M, Revel MP, Khalil A, Ferretti G, Milleron B, Laurent F. Management strategy of pulmonary nodule in 2013. Diagn Interv Imaging 2013; 94:1081-94. [PMID: 24034970 DOI: 10.1016/j.diii.2013.05.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- M Lederlin
- Service d'imagerie médicale, Université Bordeaux Segalen, CHU Bordeaux Groupe Sud, avenue de Magellan, 33600 Pessac, France.
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Kilburn-Toppin F, Arthurs OJ, Tasker AD, Set PAK. Detection of pulmonary nodules at paediatric CT: maximum intensity projections and axial source images are complementary. Pediatr Radiol 2013; 43:820-6. [PMID: 23344916 DOI: 10.1007/s00247-012-2597-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 11/13/2012] [Accepted: 11/13/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Maximum intensity projection (MIP) images might be useful in helping to differentiate small pulmonary nodules from adjacent vessels on thoracic multidetector CT (MDCT). OBJECTIVE The aim was to evaluate the benefits of axial MIP images over axial source images for the paediatric chest in an interobserver variability study. MATERIALS AND METHODS We included 46 children with extra-pulmonary solid organ malignancy who had undergone thoracic MDCT. Three radiologists independently read 2-mm axial and 10-mm MIP image datasets, recording the number of nodules, size and location, overall time taken and confidence. RESULTS There were 83 nodules (249 total reads among three readers) in 46 children (mean age 10.4 ± 4.98 years, range 0.3-15.9 years; 24 boys). Consensus read was used as the reference standard. Overall, three readers recorded significantly more nodules on MIP images (228 vs. 174; P < 0.05), improving sensitivity from 67% to 77.5% (P < 0.05) but with lower positive predictive value (96% vs. 85%, P < 0.005). MIP images took significantly less time to read (71.6 ± 43.7 s vs. 92.9 ± 48.7 s; P < 0.005) but did not improve confidence levels. CONCLUSION Using 10-mm axial MIP images for nodule detection in the paediatric chest enhances diagnostic performance, improving sensitivity and reducing reading time when compared with conventional axial thin-slice images. Axial MIP and axial source images are complementary in thoracic nodule detection.
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Affiliation(s)
- Fleur Kilburn-Toppin
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Teaching Hospitals NHS Foundation Trust, Box 219, Hills Road, Cambridge, CB2 0QQ, UK.
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Rampinelli C, Origgi D, Bellomi M. Low-dose CT: technique, reading methods and image interpretation. Cancer Imaging 2013; 12:548-56. [PMID: 23400217 PMCID: PMC3569671 DOI: 10.1102/1470-7330.2012.0049] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The National Lung Cancer Screening Trial has recently demonstrated that screening of high-risk populations with the use of low-dose computed tomography (LDCT) reduces lung cancer mortality[1]. Based on this encouraging result, the National Comprehensive Cancer Network guidelines recommended LDCT for selected patients at high risk of lung cancer[2]. This suggests that an increasing number of CT screening examinations will be performed. The LDCT technique is relatively simple but some CT parameters are important and should be accurately defined in order to achieve good diagnostic quality and minimize the delivered dose. In addition, LDCT examinations are not as easy to read as they may initially appear; different approaches and tools are available for nodule detection and measurement. Moreover, the management of positive results can be a complex process and can differ significantly from routine clinical practice. Therefore this paper deals with the LDCT technique, reading methods and interpretation in lung cancer screening, particularly for those radiologists who have little experience of the technique.
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Couraud S, Cortot AB, Greillier L, Gounant V, Mennecier B, Girard N, Besse B, Brouchet L, Castelnau O, Frappé P, Ferretti GR, Guittet L, Khalil A, Lefebure P, Laurent F, Liebart S, Molinier O, Quoix E, Revel MP, Stach B, Souquet PJ, Thomas P, Trédaniel J, Lemarié E, Zalcman G, Barlési F, Milleron B. From randomized trials to the clinic: is it time to implement individual lung-cancer screening in clinical practice? A multidisciplinary statement from French experts on behalf of the French intergroup (IFCT) and the groupe d'Oncologie de langue francaise (GOLF). Ann Oncol 2012; 24:586-97. [PMID: 23136229 PMCID: PMC3574545 DOI: 10.1093/annonc/mds476] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Despite advances in cancer therapy, mortality is still high except in early-stage tumors, and screening remains a challenge. The randomized National Lung Screening Trial (NLST), comparing annual low-dose computed tomography (LDCT) and chest X-rays, revealed a 20% decrease in lung-cancer-specific mortality. These results raised numerous questions. The French intergroup for thoracic oncology and the French-speaking oncology group convened an expert group to provide a coherent outlook on screening modalities in France. Methods A literature review was carried out and transmitted to the expert group, which was divided into three workshops to tackle specific questions, with responses presented in a plenary session. A writing committee drafted this article. Results The multidisciplinary group favored individual screening in France, when carried out as outlined in this article and after informing subjects of the benefits and risks. The target population involves subjects aged 55–74 years, who are smokers or have a 30 pack-year smoking history. Subjects should be informed about the benefits of quitting. Screening should involve LDCT scanning with specific modalities. Criteria for CT positivity and management algorithms for positive examinations are given. Conclusions Individual screening requires rigorous assessment and precise research in order to potentially develop a lung-cancer screening policy.
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Affiliation(s)
- S Couraud
- Respiratory Diseases Department, 'Hospices Civils de Lyon' Lyon University Hospital, Pierre-Bénite
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Zhao Y, de Bock GH, Vliegenthart R, van Klaveren RJ, Wang Y, Bogoni L, de Jong PA, Mali WP, van Ooijen PMA, Oudkerk M. Performance of computer-aided detection of pulmonary nodules in low-dose CT: comparison with double reading by nodule volume. Eur Radiol 2012; 22:2076-84. [PMID: 22814824 PMCID: PMC3431468 DOI: 10.1007/s00330-012-2437-y] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Revised: 12/24/2011] [Accepted: 01/08/2012] [Indexed: 11/29/2022]
Abstract
Objective To evaluate performance of computer-aided detection (CAD) beyond double reading for pulmonary nodules on low-dose computed tomography (CT) by nodule volume. Methods A total of 400 low-dose chest CT examinations were randomly selected from the NELSON lung cancer screening trial. CTs were evaluated by two independent readers and processed by CAD. A total of 1,667 findings marked by readers and/or CAD were evaluated by a consensus panel of expert chest radiologists. Performance was evaluated by calculating sensitivity of pulmonary nodule detection and number of false positives, by nodule characteristics and volume. Results According to the screening protocol, 90.9 % of the findings could be excluded from further evaluation, 49.2 % being small nodules (less than 50 mm3). Excluding small nodules reduced false-positive detections by CAD from 3.7 to 1.9 per examination. Of 151 findings that needed further evaluation, 33 (21.9 %) were detected by CAD only, one of them being diagnosed as lung cancer the following year. The sensitivity of nodule detection was 78.1 % for double reading and 96.7 % for CAD. A total of 69.7 % of nodules undetected by readers were attached nodules of which 78.3 % were vessel-attached. Conclusions CAD is valuable in lung cancer screening to improve sensitivity of pulmonary nodule detection beyond double reading, at a low false-positive rate when excluding small nodules. Key Points • Computer-aided detection (CAD) has known advantages for computed tomography (CT). • Combined CAD/nodule size cut-off parameters assist CT lung cancer screening. • This combination improves the sensitivity of pulmonary nodule detection by CT. • It increases the positive predictive value for cancer detection.
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Affiliation(s)
- Yingru Zhao
- Center for Medical Imaging - North East Netherlands, Department of Radiology, University of Groningen/University Medical Center Groningen, P.O. Box 30.001, 9700RB, Groningen, the Netherlands
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Pomerri F, Pucciarelli S, Maretto I, Perrone E, Pintacuda G, Lonardi S, Nitti D, Muzzio PC. Significance of pulmonary nodules in patients with colorectal cancer. Eur Radiol 2012; 22:1680-6. [PMID: 22466515 DOI: 10.1007/s00330-012-2431-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 01/24/2012] [Accepted: 02/16/2012] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Radiographically small pulmonary nodules (PNs) in patients with colorectal cancer are troublesome because their discovery raises concern about metastases. This study sought to establish the appropriate timing of radiological follow-up for PNs detected at initial staging evaluation of colorectal carcinoma patients. METHODS The medical records of 376 consecutive colorectal cancer patients who underwent curative surgery and had baseline and follow-up chest X-rays (CXR) and computed tomography (CT) were reviewed. RESULTS The study included 92 patients who had all CXR and chest CT available for review, at least one PN found on baseline imaging, and no synchronous neoplasms. On baseline chest CT, these 92 patients had 170 PNs altogether and 77 (45.2 %) of them were greater than 5 mm in size. Baseline CXR detected 13 PNs in 12 patients and all but 2 were larger than 5 mm. Nodule size greater than 5 mm and irregular margins were predictors of nodule growth. The mean doubling time of 24/170 (14.1 %) growing PNs was about 4 months. CONCLUSIONS Our findings suggest that baseline and follow-up CXR are pointless, and short-interval CT follow-up is warranted when PNs larger than 5 mm with irregular margins are detected on preoperative chest CT. KEY POINTS • Pulmonary nodules in colorectal cancer patients raise concern about metastasis. • Baseline and follow-up chest X-ray in colorectal cancer can be abandoned. • CT is the best technique for assessing PNs in colorectal cancer. • Short-interval CT follow-up advisable for PNs larger than 5 mm with irregular margins.
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Affiliation(s)
- Fabio Pomerri
- Oncological Radiology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
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Ferretti G. [What are the tools for post-occupational follow-up, how should they be performed and what are their performance, limits and benefit/risk ratio? Chest X-Ray and CT scan]. Rev Mal Respir 2011; 28:761-72. [PMID: 21742237 DOI: 10.1016/j.rmr.2011.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 02/17/2011] [Indexed: 10/18/2022]
Abstract
Chest radiography and computed tomography (CT) are the two radiological techniques used for the follow-up of people exposed to asbestos. Since the last conference of consensus (1999), the scientific literature has primarily covered high-resolution CT and high-resolution volume CT (HR-VCT). We consider in turn the contribution of digital thoracic radiography, recommendations for the performance of HR-VCT to ensure the quality of examination while controlling the delivered radiation dose, and the need to refer to the "CT atlas of benign diseases related to asbestos exposure", published by a group of French experts in 2007, for interpretation. The results of the published studies concerning radiography or CT are then reviewed. We note the great interobserver variability in the recognition of pleural plaques and asbestosis, indicating the need for adequate training of radiologists, and the importance of defining standardized, quantified criteria for CT abnormalities. The very low agreement between thoracic and general radiologists must be taken into account. The reading of CT scans in cases of occupational exposure to asbestos should be entrusted to thoracic radiologists or to general radiologists having validated specific training. A double interpretation of CT could be considered in medicosocial requests. CT is more sensitive than chest radiography in the detection of bronchial carcinoma but generates a great number of false positive results (96 to 99%). No scientific data are available to assess the role of imaging by either CT or chest radiography in the early detection of mesothelioma.
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Affiliation(s)
- G Ferretti
- Université J-Fourrier, BP 53, 38041 Grenoble cedex 9, France.
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Ferretti G. [Exposure to asbestos : radiography and chest CT]. JOURNAL DE RADIOLOGIE 2011; 92:450-60. [PMID: 21621114 DOI: 10.1016/j.jradio.2011.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 03/31/2011] [Indexed: 12/21/2022]
Affiliation(s)
- G Ferretti
- Université J.-Fourrier, Grenoble, France.
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Chien CC, Zhang G, Hwu Y, Liu P, Yue W, Sun J, Li Y, Xue H, Xu LX, Wang CH, Chen N, Lu CH, Lee TK, Yang YC, Lu YT, Ching YT, Shih TF, Yang PC, Je JH, Margaritondo G. Detecting small lung tumors in mouse models by refractive-index microradiology. Anal Bioanal Chem 2011; 401:827-35. [DOI: 10.1007/s00216-011-5117-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Revised: 05/10/2011] [Accepted: 05/16/2011] [Indexed: 11/28/2022]
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Félix L, Lantuejoul S, Jankowski A, Ferretti G. [Localized pure or mixed ground-glass lung opacities]. ACTA ACUST UNITED AC 2010; 90:1869-92. [PMID: 19953078 DOI: 10.1016/s0221-0363(09)73289-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Localized ground-glass opacities (GGOs) have been recently individualized and account for between 2.9% and 19% of all pulmonary nodules detected in high-risk patients included in CT screening series for lung cancer. These opacities, nodular, lobular or flat, correspond to benign lesions (localised infectious and inflammatory diseases, focal interstitial fibrosis, and atypical alveolar hyperplasia) or malignant lesions (bronchioloalveolar carcinoma, early-stage adenocarcinoma and sometimes metastases). Localized GGOs are more likely to be malignant than solid nodules and prognosis is related to the percentage of the ground-glass component. However, doubling time of pure localized malignant GGOs is longer than mixed localized malignant GGOs and even longer than the doubling time of solid malignant nodules. Therefore, localized GGOs warrant a dedicated diagnostic workup.
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Affiliation(s)
- L Félix
- Clinique Universitaire de Radiologie et Imagerie Médicale, Pôle d'Imagerie, CHU de Grenoble, France.
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Copley SJ, Bryant TH, Chambers AA, Harvey CJ, Hodson JM, Graham A, Lynch MJ, Paley MR, Partridge WJ, Rangi P, Schmitz S, Win Z, Todd JJ, Desai SR. Observer accuracy in the detection of pulmonary nodules on CT: effect of cine frame rate. Clin Radiol 2009; 65:133-6. [PMID: 20103435 DOI: 10.1016/j.crad.2009.05.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Revised: 05/07/2009] [Accepted: 05/07/2009] [Indexed: 10/20/2022]
Abstract
AIM To assess the effect of cine frame rate on the accuracy of the detection of pulmonary nodules at computed tomography (CT). MATERIALS AND METHODS CT images of 15 consecutive patients with (n = 13) or without (n = 2) pulmonary metastases were identified. Initial assessment by two thoracic radiologists provided the "actual" or reference reading. Subsequently, 10 radiologists [board certified radiologists (n = 4) or radiology residents (n = 6)] used different fixed cine frame rates for nodule detection. Within-subjects analysis of variance (ANOVA) was used to evaluate the data. RESULTS Eighty-nine nodules were identified by the thoracic radiologists (median 8, range 0-29 per patient; median diameter 9 mm, range 4-40 mm). There was a non-statistically significant trend to reduced accuracy at higher frame rates (p=0.113) with no statistically significant difference between experienced observers and residents (p = 0.79). CONCLUSION The accuracy of pulmonary nodule detection at higher cine frame rates is reduced, unrelated to observer experience.
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Affiliation(s)
- S J Copley
- Department of Radiology, Hammersmith Hospital, Imperial College NHS Trust, London W12 0HS, UK.
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