[Quantitative CT perfusion measurements in characterization of solitary pulmonary nodules: new insights and limitations]

Although computed tomography (CT) scans remain the basis of morphologic evaluation in the characterization of solitary pulmonary nodules (SPNs), perfusion CT can represent an additional feasible technique offering reproducible measurements, at least in SPNs with a diameter >10 mm. In particular, CT perfusion could reduce the number of SPNs, diagnosed as undetermined at morphologic CT, avoiding long term follow-up CT, FDG-PET studies, biopsy or unnecessary surgery with a significant reduction in healthcare costs. In order to reduce the radiation dose, an optimization of the CT perfusion protocol could be obtained using axial mode acquisition, using shorter acquisition time and adaptative statistical iterative reconstruction algorithm.