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Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Related Experiment Video

Updated: May 2, 2026

Construction of a Preclinical Multimodality Phantom Using Tissue-mimicking Materials for Quality Assurance in Tumor Size Measurement
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Variability in Mediastinal Lymph Node Measurements in Chest Contrast-enhanced CT: Time to Change the Paradigm?

Alon Olesinksi1, Richard Lederman2, Yusef Azraq2

  • 1School of Computer Science and Engineering, The Hebrew University of Jerusalem.

Journal of Thoracic Imaging
|October 17, 2025
PubMed
Summary

Mediastinal lymph node size measurement shows high agreement between radiologists and automated methods. Automated SAL measurements from manual delineations offer a reliable, time-saving tool for classifying lymph node enlargement.

Keywords:
enlarged and normal lymph nodes classificationmediastinal lymph nodesobserver variabilityshort axis measurement

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Area of Science:

  • Radiology
  • Medical Imaging
  • Oncology

Background:

  • Accurate measurement of mediastinal lymph nodes (LNs) is crucial for patient assessment.
  • Short axis length (SAL) is manually measured on CT scans, with SAL ≥10 mm indicating pathological enlargement.

Purpose of the Study:

  • To quantify interobserver agreement and variability in manual SAL measurements.
  • To compare manual SAL measurements with automatically computed SALs from manual LN delineations.
  • To establish the mean SAL measurement error.

Main Methods:

  • Two radiologists independently measured SALs of 451 LNs in 40 contrast-enhanced chest CT scans.
  • One radiologist also manually delineated LN contours for automated SAL computation.
  • Bland-Altman statistics were used to analyze differences between measurements.

Main Results:

  • High overall agreement (93.8%) was observed between radiologists for normal/enlarged LN classification.
  • Interobserver SAL differences were 1.1 mm for agreement and 3.5 mm for disagreement.
  • Agreement between manual and automatically computed SALs was 92.7%, similar to interobserver variability.

Conclusions:

  • Classification of mediastinal LNs by SAL measurement shows high agreement.
  • Automated SAL computation from manual delineations is a reliable and time-saving tool.
  • A 3-tier classification (normal <8 mm, possibly enlarged 8-12 mm, definitely enlarged >12 mm) is supported by the ±2 mm error margin.