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Lung nodule enhancement at CT: prospective findings
S J Swensen1, L R Brown, T V Colby
1Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Radiology
|November 1, 1996
Summary
Lung nodule enhancement on computed tomography (CT) indicates malignancy and vascularity. Higher enhancement levels in pulmonary nodules correlate with increased likelihood of cancer, aiding diagnosis.
Area of Science:
- Radiology
- Oncology
- Pathology
Background:
- Pulmonary nodules require accurate characterization to differentiate between malignant and benign causes.
- Computed tomography (CT) with contrast enhancement is a key imaging modality for evaluating lung nodules.
Purpose of the Study:
- To investigate the relationship between lung nodule enhancement measured by CT and the probability of malignancy.
- To assess if CT enhancement correlates with nodule vascularity.
Main Methods:
- Studied 107 patients with 7-30 mm indeterminate pulmonary nodules (52 malignant, 51 granulomas, 4 benign neoplasms).
- Recorded nodule attenuation from serial thin-section CT scans before and after contrast administration.
- Histologic specimens (n=24) were graded for vascularity using immunoperoxidase staining for factor VIII-associated antigen.
Main Results:
- Malignant neoplasms showed significantly higher enhancement (median 46.5 HU) compared to benign lesions (median 8 HU) (P < .001).
- Using a 20 HU threshold, CT enhancement achieved 98% sensitivity, 73% specificity, and 85% accuracy for malignancy detection.
- The degree of nodule enhancement was significantly correlated with vascular staining (P < .001).
Conclusions:
- CT-measured enhancement is a valuable indicator of both malignancy and vascularity in pulmonary nodules.
- These findings support the use of contrast-enhanced CT for improving the diagnostic accuracy of indeterminate lung nodules.