Diagnostic accuracy of MIP slice modalities for small pulmonary nodules in paediatric oncology patients revisited: What is additional from the paediatric radiologist approach?

• Published in: Egyptian journal of radiology and nuclear medicine Vol. 47; no. 4; pp. 1629 - 1637
• Main Authors: Burak Özkan, Mehmet, Tscheuner, Sebastian, Ozkan, Elif
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.12.2016; SpringerOpen
• Subjects: Maximum intensity projection; MIP; Oncology; Paediatric radiology; Pulmonary nodule; CT; Oncology; Maximum intensity projection; Paediatric radiology; MIP; Pulmonary nodule
• ISSN: 0378-603X
• DOI: 10.1016/j.ejrnm.2016.09.008

Maximum intensity projection (MIP) CT image reconstruction is a beneficial diagnostic tool in paediatric radiology and can help to distinguish between small pulmonary nodules and adjacent vessels or pulmonary scars. The purpose of this study was to determine the optimal MIP slice thickness and reconstruction plane for pulmonary nodule detection in paediatric patients. Fifty-five paediatric patients with suspected nodules less than 5mm who were diagnosed with extra-pulmonary malignancy and underwent multidetector computed tomography (MDCT) of the thorax were evaluated. Multiplanar CT 5 mm MIP reconstruction (axial-coronal-sagittal), 2mm axial-coronal MIPs, and 1-mm and 5-mm axial source slices, were interpreted independently by three blinded radiologists. The axial -1mm slices were accepted as the gold standard method as the result of retrospective consensus session in order to get comparison with similar studies. The number of nodules, size and location, distance from pleura, overall time taken and confidence were recorded separately for each observer. Receiver operating characteristic (ROC) analysis showed significant advantages of MIP images over averaged images. With high significance (p<0.001), coronal 5mm MIP reconstructions were found to be most advantageous over conventional reconstruction techniques. Mean reading time was fastest in axial 5mm MIP images. Compared to conventional paediatric chest CT reconstruction techniques, detection of pulmonary nodules with diameters smaller than 5mm was found to be most sensitive in 5mm coronal MIP images. Diagnostic accuracy of MIP slice modalities for small pulmonary nodules in paediatric oncology patients revisited: What is additional from the paediatric radiologist approach?