The Effects of Computed Tomography with Iterative Reconstruction on Solid Pulmonary Nodule Volume QuantificationReportar como inadecuado

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The objectives of this study were to evaluate the influence of iterative reconstruction IR on pulmonary nodule volumetry with chest computed tomography CT.


Twenty patients 12 women and 8 men, mean age 61.9, range 32–87 underwent evaluation of pulmonary nodules with a 64-slice CT-scanner. Data were reconstructed using filtered back projection FBP and IR Philips Healthcare, iDose4-levels 2, 4 and 6 at similar radiation dose. Volumetric nodule measurements were performed with semi-automatic software on thin slice reconstructions. Only solid pulmonary nodules were measured, no additional selection criteria were used for the nature of nodules. For intra-observer and inter-observer variability, measurements were performed once by one observer and twice by another observer. Algorithms were compared using the concordance correlation-coefficient pc and Friedman-test, and post-hoc analysis with the Wilcoxon-signed ranks-test with Bonferroni-correction significance-level p<0.017.


Seventy-eight nodules were present including 56 small nodules volume<200 mm3, diameter<8 mm and 22 large nodules volume≥200 mm3, diameter≥8 mm. No significant differences in measured pulmonary nodule volumes between FBP, iDose4-levels 2, 4 and 6 were found in both small nodules and large nodules. FBP and iDose4-levels 2, 4 and 6 were correlated with pc-values of 0.98 or higher for both small and large nodules. Pc-values of intra-observer and inter-observer variability were 0.98 or higher.


Measurements of solid pulmonary nodule volume measured with standard-FBP were comparable with IR, regardless of the IR-level and no significant differences between measured volumes of both small and large solid nodules were found.

Autor: Martin J. Willemink , Jaap Borstlap, Richard A. P. Takx, Arnold M. R. Schilham, Tim Leiner, Ricardo P. J. Budde, Pim A. de Jong



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