Lung nodule enhancement at CT: prospective findings

• Published in: Radiology Vol. 201; no. 2; p. 447
• Main Authors: Swensen, S J, Brown, L R, Colby, T V, Weaver, A L, Midthun, D E
• Format: Journal Article
• Language: English
• Published: United States 01.11.1996
• Subjects: Adult; Aged; Aged, 80 and over; Contrast Media; Female; Granuloma - diagnostic imaging; Humans; Iopamidol; Lung Neoplasms - diagnostic imaging; Male; Middle Aged; Prospective Studies; ROC Curve; Sensitivity and Specificity; Solitary Pulmonary Nodule - diagnostic imaging; Tomography, X-Ray Computed
• ISSN: 0033-8419
• DOI: 10.1148/radiology.201.2.8888239

To determine if lung nodule enhancement measured with computed tomography (CT) is directly related to the likelihood of malignancy and to nodule vascularity. Radiologically indeterminate 7-30-mm pulmonary nodules were studied in 107 patients with malignant neoplasms (n = 52), granulomas (n = 51), and benign neoplasms (n = 4). Attenuation was recorded from serial thin-section CT scans before and after injection of contrast material. Twenty-four histologic specimens were graded after immunoperoxidase vascular staining with antibody to factor VIII-associated antigen. Malignant neoplasms were enhanced (median, 46.5 HU; range, 11-110 HU) statistically significantly more than granulomas and benign neoplasms (median, 8 HU; range, -10 to 94 HU) (P < .001). With 20 HU as the threshold for a positive test result, the sensitivity was 98%, specificity was 73%, and accuracy was 85% (prevalence of malignancy, 49% ¿52 of 107 nodules]). The degree of enhancement was statistically significantly related to the amount of central vascular staining (P < .001). Enhancement appears to be an indicator of malignancy and vascularity. These prospective findings corroborate previously reported results.