title: Pulmonary nodules: CT evaluation of enhancement with iodinated contrast material.
abstract: OBJECTIVE
  To determine if the degree of enhancement of pulmonary nodules is directly related to the likelihood of malignancy and to the vascularity of the nodule.
  
  
  METHODS
  Uncalcified 6-40-mm-diameter pulmonary nodules were studied in 163 patients with malignant neoplasm (n = 111), granuloma (n = 43), and benign neoplasm (n = 9). Serial thin-section computed tomography (CT) was performed before and after injection of 100 mL of nonionic contrast material at 2 mL/sec. The maximum level of enhancement was recorded. Eighteen histologic specimens were graded after vascular staining.
  
  
  RESULTS
  Malignant neoplasms enhanced (median, 40.0 HU; range, 20-108 HU) significantly more than granulomas and benign neoplasms (median, 12.0 HU; range, -4 to 58 HU) (P < .001). With 20 HU as the threshold for a positive test, sensitivity was 100%; specificity, 76.9%; positive predictive value, 90.2%; negative predictive value, 100%; and accuracy, 92.6% (prevalence of malignancy, 68.1%). Degree of enhancement was significantly related to amount of central vascular staining (P = .003).
  
  
  CONCLUSIONS
  Enhancement is an indicator of malignancy and vascularity.
authors: Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905.
authors: S J
authors: SJ
authors: Swensen
authors: L R
authors: LR
authors: Brown
authors: T V
authors: TV
authors: Colby
authors: A L
authors: AL
authors: Weaver
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006099:Granuloma / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007472:Iohexol; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D007472:Iohexol