Eun Ah Park, Presenter: Nothing to Disclose

Jin Mo Goo MD, PhD, Abstract Co-Author: Nothing to Disclose

Hyun Ju Lee MD, Abstract Co-Author: Nothing to Disclose

Chang Hyun Lee MD, Abstract Co-Author: Nothing to Disclose

Chang Min Park, Abstract Co-Author: Nothing to Disclose

Ho Yun Lee MD, Abstract Co-Author: Nothing to Disclose

Jung-Gi Im MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Metastatectomy may be a potential treatment method for patients with lung metastasis from extrapulmonary malignancies. The aim of this study is to compare the effects of the computer-aided detection (CAD) system and sliding-thin-slab maximum intensity projection (MIP) technique on the detection of pulmonary nodules at MDCT in patients undergoing metastatectomy.

Fifty-six consecutive patients with lung metastasis from extrapulmonary malignancies who underwent metastatectomy were enrolled. Four chest radiologists analyzed preoperative 1-mm section CT images and recorded the locus of each nodule candidate. Then, two radiologists reevaluated the images, first with CAD software then with thin-slab MIP; the other two radiologists, with thin-slab MIP first then CAD. The reference standard was established by a consensus panel and pathologic records.

A total of 582 nodules were identified by a consensus panel. Of 230 nodules surgically removed, 138 nodules were malignant. Overall sensitivity for all nodules with thin-section CT scans alone was 47%, 49%, 40%, and 40% for each radiologist, respectively. In comparison, the sensitivity for all nodules increased to 61%, 61%, 58%, and 60% with CAD (p 0.05 for all). The average number of false-positive findings per patient was 0.8 with thin-section CT alone, 1.1 with CAD, and 1.4 with MIP.

In candidates for metastatectomy, both CAD and MIP helped detect more nodules, but in detecting pathologically proven malignant nodules, only the reading with CAD showed better performance than the reading using thin-section CT alone.

Many malignant nodules in candidates for metastatectomy can be missed. Therefore, for proper candidate selection and surgical planning, the enhancing tools of CAD and MIP are needed.

Park, E, Goo, J, Lee, H, Lee, C, Park, C, Lee, H, Im, J, et al, , et al, , Comparison of Enhancing Tools for Malignant Lung Nodule Detection in Candidates for Metastatectomy: Computer-aided Detection System and Sliding-Thin-Slab Maximum Intensity Projection Technique.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5012106.html