Joo Sung Sun MD, Abstract Co-Author: Nothing to Disclose

Eun Young Kim MD, Presenter: Nothing to Disclose

Seon Young Park MD, Abstract Co-Author: Nothing to Disclose

Young Keun Sur MD, Abstract Co-Author: Nothing to Disclose

Jin Wook Choi MD, Abstract Co-Author: Nothing to Disclose

Eun Ju Ha, Abstract Co-Author: Nothing to Disclose

Sung Hoon Park MD, Abstract Co-Author: Nothing to Disclose

Sung Jung Kim, Abstract Co-Author: Nothing to Disclose

Tae Sun Han, Abstract Co-Author: Nothing to Disclose

Boram Yi MD, Abstract Co-Author: Nothing to Disclose

Jae Yong Cho MD, Abstract Co-Author: Nothing to Disclose

Hun Cho MD, Abstract Co-Author: Nothing to Disclose

Kyung Joo Park MD, Abstract Co-Author: Nothing to Disclose

To correlate MDCT volumetric information of calcification of SPN and visual assessment of calcification of SPN on CXR

Retrospective review of consecutive 221 SPNs that were identified by both CXR and thin-section chest CT. Eleven observers who blinded to the results of CT assessment about calcification reviewed all CXR. They scored each nodules with 5 confidence scale in terms of nodule calcification. Reference standard for calcification of SPN was made by 2 radiologist consensus reading and they were not involved review of CXR. Volumetric information of calcification was acquired by using commercial software. ROC analysis was done and AUC was obtained to analyse overall diagnostic performance. For ROC analysis, 2431 nodules (221*11) were used as target nodules. Intraclass correlation coefficient (ICC) for inter-rater reliability was calculated. ROC analysis and ICC were calculated according to the nodule size. Group1 ( < 10mm),Group2(10~20mm),group3(greater than 20mm).

Among 221 SPNs (mean diameter 13.9mm), a total of 76 SPNs were calcified (34.4%). Average percentage of calcification (>=160 HU) in all each 76 calcified nodules was 41.5%. Average percentage of calcification of 17 focal calcified nodules and 59 definite benign calcified one was 4.16% (Figure 1) and 49.72% respectively. There was significant correlation between confidence and nodule calcification. Correlation coefficient (r) was 0.625 (p < .001). The positive predictive value of a “confidence 5” assessment was 0.95, and the negative predictive value of a “confidence 1” assessment was 0.952 in case of nodule < 10mm. AUC for group 1, 2, 3 , and all nodules was 0.835, 0.639, 0.6 ,and 0.71 respectively. AUC for group 1 ( < 10mm) was significantly higher than those of group 2 and 3 (p < 0.0001). ICC for group 1, 2, 3, and all nodules, was 0.65, 0.48, 0.33, and 0.51 respectively.

Overall diagnostic performance of perception of nodule calcification was best in nodules less than 10mm diameter. SPNs depicting benign calcification would contain about 50% of calcification in their volume.

Misdiagnosis of non calcified nodule as calcified one on CXR reading could lead bad choice for management of SPN. Diagnostic performance for identifying calcification is low in case of nodules >= 10mm in diameter, so that we should carefully evaluate calcification when nodule size is greater than 10 mm.

Sun, J, Kim, E, Park, S, Sur, Y, Choi, J, Ha, E, Park, S, Kim, S, Han, T, Yi, B, Cho, J, Cho, H, Park, K, Visual Assessment of Calcification of Solitary Pulmonary Nodule (SPN) on Chest Radiography (CXR) According to the Nodule Size: Correlation with MDCT Volumetric Measurement of Calcification.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045652.html