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Updated: Dec 7, 2025

Author Spotlight: A 3D Digital Model for the Diagnosis and Treatment of Pulmonary Nodules
Published on: May 19, 2023
Accuracy of Pulmonary Nodule Volumetry Using Noise-Optimized Virtual Monoenergetic Image and Nonlinear Blending Image
Changjiu He1, Jieke Liu1, Shibei Hu1
1From the Department of Radiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China.
Objective:
The aim of the study was to assess accuracy of pulmonary nodule volumetry using noise-optimized virtual monoenergetic image (VMI+) and nonlinear blending image (NBI) algorithms in dual-energy computed tomography (DECT).
Methods:
An anthropomorphic chest phantom with 10 simulated nodules (5 solid nodules and 5 ground-glass opacities) was scanned using DECT80/Sn140kV, DECT100/Sn140kV, and single-energy CT (SECT120kV/200mAs), respectively. The dual-energy images were reconstructed using VMI+ (70 keV) and NBI algorithms. The contrast-to-noise ratio and absolute percentage error (APE) of nodule volume were measured to assess image quality and accuracy of nodule volumetry. The radiation dose was also estimated.
Results:
The contrast-to-noise ratio of SECT120kV/200mAs was significantly higher than that of NBI80/Sn140kV and VMI+80/Sn140kV (both corrected P < 0.05), whereas there were no significant differences between NBI100/sn140kV and SECT120kV/200mAs and between VMI+100/sn140kV and SECT120kV/200mAs (both corrected P > 0.05). The APE of SECT120kV/200mAs was significantly lower than that of NBI80/Sn140kV and VMI+80/Sn140kV in both types of nodules (all corrected P < 0.05), whereas there were no significant differences between VMI+100/sn140kV and SECT120kV/200mAs in solid nodules and between NBI100/Sn140kV and SECT120kV/200mAs in ground-glass opacities (both corrected P > 0.05). The radiation dose of DECT100/Sn140kV and DECT80/Sn140kV were significantly lower than that of SECT120kV/200mAs (both corrected P < 0.05).
Conclusions:
The DECT100/sn140kV can ensure image quality and nodule volumetry accuracy with lower radiation dose compared with SECT120kV/200mAs. Specifically, the VMI+ algorithm could be used in solid nodules and NBI algorithm in ground-glass opacities.
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