RSNA 2003 

Abstract Archives of the RSNA, 2003


MIPs, Multiplanar Reformats and Dedicated Display Tools for the Detection and Evaluation of Focal Lung Disease

Scientific Papers

Presented on December 4, 2003
Presented as part of Q02: Chest (High-Resolution CT)


Bernhard Baumert MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To assess the effect of a dedicated software environment with alternative display methods and advanced visualization tools (LungCare, Siemens) on the detection and classification of focal lung disease at multidetector-row CT (MDCT) of the chest. Methods and Materials: 25 thoracic CT studies were acquired by 16-slice MDCT (Siemens) and reconstructed with a slice thickness of 0.75mm. Studies contained between 3 and 12 lung nodules (166 total). As an independent gold standard, twentynine 2-4mm lung nodules had been artificially inserted. Over the course of 4 months, 3 radiologists with different levels of experience independently evaluated all data sets, each displayed with 9 different techniques: 0.75mm original axial slices, 3mm and 5mm axial multiplanar reformats (MPRs), 5mm and 10mm sliding axial maximum intensity projections (MIPs), 3mm and 10mm coronal MPRs, and 5mm and 10mm sliding coronal MIPs. Confidence of lesion detection was rated on a 4-point scale. For size determination of lung lesions use of electronic calipers with axials/MPRs and 3D automated nodule volumetry with MIPs was available. Readers were asked to evaluate each lesion and recommend immediate invasive work-up (dł10mm), or 3 months (dł5mm) or 6 months (d<5mm) follow-up. Reading time for each display mode was recorded. Results: Average sensitivities were highest with 5mm and 10mm coronal MIPs (both 98%) and lowest with 0.75mm axials and 3mm or 5mm axial MPRs (all 51%) in the assessment of artificial lung lesions. The total number of identified lesions was highest (99%) and lowest (69%-70%) with the same display methods. The average confidence score for lesion detection was highest (3.9) with 10mm coronal MIPs and lowest (2.7) with 3mm axial MPRs. Average inter-reader agreement on recommended lesion/patient management was k=0.77 when electronic calipers and k=0.89 when 3D nodule volumetry were available. Average reading time for each case was shortest with 5mm coronal MIPs (4.02 min) and longest with the original 0.75mm axial images (6.04 min). The 3 readers did not differ significantly in nodule analysis, but reading time decreased with more clinical experience with all methods. Conclusion: Dedicated software environments, with alternative display methods and advanced visualization tools, improve reader performance in the diagnosis of focal lung disease. Sliding coronal MIP reconstructions provide highest sensitivity and confidence in lesion detection and improve inter-reader consistency in recommended patient management. (U.S. received a grant from Siemens Medical Solutions; B.B. is the 2002/2003 International BWH/Harvard-Siemens CT Research Fellow.) Questions about this event email:

Cite This Abstract

Baumert MD, B, MIPs, Multiplanar Reformats and Dedicated Display Tools for the Detection and Evaluation of Focal Lung Disease.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.