Higashihara Hiroki, Osuga Keigo, Azuma Takeo, Nakazawa Tetsuro, Yanagawa Masahiro, Kikuyama Ayano, Maeda Noboru, Tomiyama Noriyuki
Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan.
Acta Radiol. 2011 Nov 1;52(9):964-8. doi: 10.1258/ar.2011.110187. Epub 2011 Oct 3.
Evaluation of detection of lung nodules by C-arm CT (CACT) is important before this procedure can be used to guide percutaneous lung interventions.
To compare the efficacy of CACT with CT in the detection of pulmonary nodules using a phantom lung.
A phantom lung containing 12 phantom nodules in four sizes (5 mm/8 mm/10 mm/12 mm) and three CT values (one solid nodule, +100 HU; two ground glass nodules, -630 and -800 HU) was used. Six sessions of CACT (slice thickness 4.5 mm) and CT (slice thickness 5 mm) were performed. In each session, the locations of nodules were arbitrarily changed in the phantom. Three radiologists assessed the detection of a total of 72 nodules. Statistical analysis was performed for the sensitivity and positive predictive value of lung nodules between CACT and CT by the McNemar test and paired t-test (P < 0.05).
Sensitivity did not differ between CACT and CT, respectively (reader 1, 82% vs. 88%, P = 0.22; reader 2, 82% vs. 78%, P = 0.37; reader 3, 79% vs. 83%, P = 0.48). For nodules of 8 mm or larger, the sensitivity increased for each reader and showed no significant difference between CACT vs. CT. The positive predictive value did not differ between CACT and CT.
In this phantom study, CT and CACT show similar sensitivity for the detection of pulmonary nodules. CACT could be used in percutaneous interventional procedures in the lungs.
在C形臂CT(CACT)用于指导经皮肺介入治疗之前,评估其对肺结节的检测能力很重要。
使用模拟肺比较CACT与CT在检测肺结节方面的效果。
使用一个模拟肺,其中包含12个模拟结节,有四种尺寸(5毫米/8毫米/10毫米/12毫米)和三种CT值(一个实性结节,+100HU;两个磨玻璃结节,-630和-800HU)。进行了六次CACT(层厚4.5毫米)和CT(层厚5毫米)扫描。在每次扫描中,模拟肺内结节的位置被任意改变。三位放射科医生评估了总共72个结节的检测情况。通过McNemar检验和配对t检验(P<0.05)对CACT和CT之间肺结节的敏感性和阳性预测值进行了统计分析。
CACT和CT的敏感性分别无差异(读者1,82%对88%,P=0.22;读者2,82%对78%,P=0.37;读者3,79%对83%,P=0.48)。对于8毫米及以上的结节,每位读者的敏感性均有所提高,且CACT与CT之间无显著差异。CACT和CT的阳性预测值无差异。
在这项模拟研究中,CT和CACT在检测肺结节方面显示出相似的敏感性。CACT可用于肺部的经皮介入手术。