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Detection of pulmonary nodules at multirow-detector CT: effectiveness of double reading to improve sensitivity at standard-dose and low-dose chest CT

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Abstract

The purpose of this study was to assess the effectiveness of double reading to increase the sensitivity of lung nodule detection at standard-dose (SDCT) and low-dose multirow-detector CT (LDCT). SDCT (100 mAs effective tube current) and LDCT (20 mAs) of nine patients with pulmonary metastases were obtained within 5 min using four-row detector CT. Softcopy images reconstructed with 5-mm slice thickness were read by three radiologists independently. Images with 1.25-mm slice thickness served as the gold standard. Sensitivity was assessed for single readers and combinations. The effectiveness of double reading was expressed as the increase of sensitivity. Average sensitivity for detection of 390 nodules (size 3.9±3.2 mm) for single readers was 0.63 (SDCT) and 0.64 (LDCT). Double reading significantly increased sensitivity to 0.74 and 0.79, respectively. No significant difference between sensitivity at SDCT and LDCT was observed. The percentage of nodules detected by all three readers concordantly was 52% for SDCT and 47% for LDCT. Although double reading increased the detection rate of pulmonary nodules from 63% to 74–79%, a considerable proportion of nodules remained undetected. No difference between sensitivities at LDCT and SDCT for detection of small nodules was observed.

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References

  1. Kaneko M, Eguchi K, Ohmatsu H, Kakinuma R, Naruke T, Suemasu K, Moriyama N (1996) Peripheral lung cancer: screening and detection with low-dose spiral CT versus radiography. Radiology 201:798–802

    CAS  PubMed  Google Scholar 

  2. Sone S, Takashima S, Li F, Yang Z, Honda T, Maruyama Y, Hasegawa M, Yamanda T, Kubo K, Hanamura K, Asakura K (1998) Mass screening for lung cancer with mobile spiral computed tomography scanner. Lancet 351:1242–1245

    Article  CAS  PubMed  Google Scholar 

  3. Henschke CI, McCauley DI, Yankelevitz DF, Naidich DP, McGuinness G, Miettinen OS, Libby DM, Pasmantier MW, Koizumi J, Altorki NK, Smith JP (1999) Early lung cancer action project: overall design and findings from baseline screening. Lancet 354:99–105

    Article  CAS  PubMed  Google Scholar 

  4. Diederich S, Wormanns D, Semik M, Thomas M, Lenzen H, Roos N, Heindel W (2002) Screening for early lung cancer with low-dose spiral CT: prevalence in 817 asymptomatic smokers. Radiology 222:773–781

    PubMed  Google Scholar 

  5. Swensen SJ, Jett JR, Sloan JA, Midthun DE, Hartman TE, Sykes AM, Aughenbaugh GL, Zink FE, Hillman SL, Noetzel GR, Marks RS, Clayton AC, Pairolero PC (2002) Screening for lung cancer with low-dose spiral computed tomography. Am J Respir Crit Care Med 165:508–513

    PubMed  Google Scholar 

  6. Pastorino U, Bellomi M, Landoni C, De Fiori E, Arnaldi P, Picchio M, Pelosi G, Boyle P, Fazio F (2003) Early lung-cancer detection with spiral CT and positron emission tomography in heavy smokers: 2-year results. Lancet 362:593–597

    Article  PubMed  Google Scholar 

  7. Yankelevitz DF, Reeves AP, Kostis WJ, Zhao B, Henschke CI (2000) Small pulmonary nodules: volumetrically determined growth rates based on CT evaluation. Radiology 217:251–256

    CAS  PubMed  Google Scholar 

  8. Takashima S, Sone S, Li F, Maruyama Y, Hasegawa M, Kadoya M (2003) Indeterminate solitary pulmonary nodules revealed at population-based CT screening of the lung: using first follow-up diagnostic CT to differentiate benign and malignant lesions. Am J Roentgenol 180:1255–1263

    Google Scholar 

  9. Seltzer SE, Judy PF, Adams DF, Jacobson FL, Stark P, Kikinis R, Swensson RG, Hooton S, Head B, Feldman U (1995) Spiral CT of the chest: comparison of cine and film-based viewing. Radiology 197:73–78

    CAS  PubMed  Google Scholar 

  10. Diederich S, Semik M, Lentschig MG, Winter F, Scheld HH, Roos N, Bongartz G (1999) Helical CT of pulmonary nodules in patients with extrathoracic malignancy: CT-surgical correlation. Am J Roentgenol 172:353–360

    CAS  Google Scholar 

  11. Kozuka T, Johkoh T, Hamada S, Naito H, Tomiyama N, Koyama M, Mihara N, Honda O, Nakamura H, Kudo M (2003) Detection of pulmonary metastases with multi-detector row CT scans of 5-mm nominal section thickness: autopsy lung study. Radiology 226:231–234

    PubMed  Google Scholar 

  12. Wormanns D, Fiebich M, Saidi M, Diederich S, Heindel W (2002) Automatic detection of pulmonary nodules at spiral CT: clinical application of a computer-aided diagnosis system. Eur Radiol 12:1052–1057

    Article  PubMed  Google Scholar 

  13. Rusinek H, Naidich DP, McGuinness G, Leitman BS, McCauley DI, Krinsky GA, Clayton K, Cohen H (1998) Pulmonary nodule detection: low-dose versus conventional CT. Radiology 209:243–249

    CAS  PubMed  Google Scholar 

  14. Gartenschläger M, Schweden F, Gast K, Westermeier T, Kauczor H, von Zitzewitz H, Thelen M (1998) Pulmonary nodules: detection with low-dose vs conventional-dose spiral CT. Eur Radiol 8:609–614

    Article  PubMed  Google Scholar 

  15. Diederich S, Lenzen H, Windmann R, Puskas Z, Yelbuz TM, Henneken S, Klaiber T, Eameri M, Roos N, Peters PE (1999) Pulmonary nodules: experimental and clinical studies at low-dose CT. Radiology 213:289–298

    CAS  PubMed  Google Scholar 

  16. Karabulut N, Toru M, Gelebek V, Gulsun M, Ariyurek OM (2002) Comparison of low-dose and standard-dose helical CT in the evaluation of pulmonary nodules. Eur Radiol 12:2764–2769

    PubMed  Google Scholar 

  17. Ciatto S, Rosselli DT, Burke P, Visioli C, Paci E, Zappa M (2003) Comparison of standard and double reading and computer-aided detection (CAD) of interval cancers at prior negative screening mammograms: blind review. Br J Cancer 89:1645–1649

    Article  CAS  PubMed  Google Scholar 

  18. Altman DG (1991) Practical statistics for medical research. Chapman & Hall, London

    Google Scholar 

  19. Naidich DP, Marshall CH, Gribbin C, Arams RS, McCauley DI (1990) Low-dose CT of the lungs: preliminary observations. Radiology 175:729–731

    CAS  PubMed  Google Scholar 

  20. Novak CL, Qian J, Fan L, Ko JP, Rubinowitz AN, McGuiness G, Naidich DP (2002) Inter-observer variations on interpretation of multi-slice CT lung cancer screening studies, and the implications for computer-aided diagnosis. Proceedings of SPIE 4684: 68–79

    Article  Google Scholar 

  21. Wormanns D, Beyer F, Diederich S, Ludwig K, Heindel W (2004) Diagnostic performance of a commercially available computer-aided diagnosis system for automatic detection of pulmonary nodules: comparison with single and double reading. Fortschr Roentgenstr 176:953–958

    CAS  Google Scholar 

  22. Marten K, Seyfarth T, Auer F, Wiener E, Grillhosl A, Obenauer S, Rummeny EJ, Engelke C (2004) Computer-assisted detection of pulmonary nodules: performance evaluation of an expert knowledge-based detection system in consensus reading with experienced and inexperienced chest radiologists. Eur Radiol 14:1930–1938

    Article  PubMed  Google Scholar 

  23. Diederich S, Thomas M, Semik M, Lenzen H, Roos N, Weber A, Heindel W, Wormanns D (2004) Screening for early lung cancer with low-dose spiral computed tomography: results of annual follow-up examinations in asymptomatic smokers. Eur Radiol 14:691–702

    Article  PubMed  Google Scholar 

  24. Fischbach F, Knollmann F, Griesshaber V, Freund T, Akkol E, Felix R (2003) Detection of pulmonary nodules by multislice computed tomography: improved detection rate with reduced slice thickness. Eur Radiol 13:2378–2383

    Article  PubMed  Google Scholar 

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Acknowledgment

The authors would like to express their thanks to Robert Kralemann for his support in the practical realization of the study and for entering the data into the computer system.

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Correspondence to Dag Wormanns.

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Wormanns, D., Ludwig, K., Beyer, F. et al. Detection of pulmonary nodules at multirow-detector CT: effectiveness of double reading to improve sensitivity at standard-dose and low-dose chest CT. Eur Radiol 15, 14–22 (2005). https://doi.org/10.1007/s00330-004-2527-6

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  • DOI: https://doi.org/10.1007/s00330-004-2527-6

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