Related Experiment Video
Updated: Aug 15, 2026
Three-Dimensional Reconstruction for the Whole Lung with Early Multiple Pulmonary Nodules
Published on: October 13, 2023
Solitary pulmonary nodule: characterization with combined wash-in and washout features at dynamic multi-detector row
Yeon Joo Jeong1, Kyung Soo Lee, Sun Young Jeong
1Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-Ku, Seoul 135-710, Korea.
Purpose:
To prospectively assess the accuracy of combined wash-in and washout characteristics at dynamic contrast material-enhanced multi-detector row computed tomography (CT) in distinguishing benign from malignant solitary pulmonary nodules.
Materials And Methods:
Institutional review board approval and informed consent were obtained. The study included 107 patients (62 men, 45 women; mean age, 55 years; range, 22-81 years) with a solitary pulmonary nodule. After unenhanced CT (2.5-mm collimation) scans were obtained, dynamic CT was performed by using a helical technique (series of images obtained throughout the nodule, with 2.5-mm collimation, at 30, 60, 90, and 120 seconds and 4, 5, 9, 12, and 15 minutes) after intravenous injection of contrast medium (120 mL). Tissue diagnosis was made in 70 nodules, and follow-up images showed benignancy in the remaining 37 (no change in size, n = 32; decrease in size, n = 5). CT findings were analyzed in terms of wash-in and washout of contrast medium. Sensitivity, specificity, and accuracy for malignant nodules were calculated by considering both the wash-in and washout characteristics at dynamic CT.
Results:
There were 49 malignant and 58 benign nodules. When diagnostic criteria for malignancy of both wash-in of 25 HU or greater and washout of 5-31 HU were applied, sensitivity, specificity, and accuracy for malignancy were 94% (46 of 49 nodules), 90% (52 of 58 nodules), and 92% (98 of 107 nodules), respectively. Of 58 benign nodules, 27 showed less than 25 HU wash-in, 14 showed persistent contrast enhancement without washout and with wash-in of 25 HU or greater, and 11 showed washout greater than 31 HU and wash-in of 25 HU or greater.
Conclusion:
Evaluation of solitary pulmonary nodules by analyzing combined wash-in and washout characteristics at dynamic contrast-enhanced multi-detector row CT showed 92% accuracy for distinguishing benign nodules from malignant nodules.
