title: Value of axial and coronal maximum intensity projection (MIP) images in the detection of pulmonary nodules by multislice spiral CT: comparison with axial 1-mm and 5-mm slices.
abstract: The purpose of this study was to investigate the diagnostic accuracy of non-overlapping 10-mm axial and coronal maximum intensity projections (MIP) in comparison with standard axial 1-mm and 5-mm slices in the detection of pulmonary nodules. Sixty patients with suspected nodules who underwent multislice spiral CT of the chest were evaluated. Axial 1-mm and 5-mm slices as well as non-overlapping 10-mm axial/coronal MIPs were interpreted independently by three blinded radiologists. After initial review, a retrospective consensus session was performed for agreement on final nodule counts using the axial 1-mm slices as gold standard. Small nodules of less than 5 mm in size were most accurately detected by the axial MIPs. Receiver operating characteristic (ROC) analysis of these small nodules showed that 5-mm slices were not capable of a statistically significant differentiation of nodules from other focal lesions in two observers (p=0.034 and p=0.012, respectively) whereas 1-mm slices and coronal/axial MIPs did allow a statistically significant differentiation in all observers (p<0.001). Nodules larger than 5 mm were equally well depicted with all modalities. Non-overlapping 10-mm axial MIPs improve the accuracy in the detection of small pulmonary nodules.
authors.affiliation: Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany. vray@gmx.net
authors.forename: Ray
authors.initials: R
authors.lastname: Valencia
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.forename: Lukas
authors.initials: L
authors.lastname: Lehmkuhl
authors.forename: Frank
authors.initials: F
authors.lastname: Fischbach
authors.forename: Roland
authors.initials: R
authors.lastname: Felix
authors.forename: Friedrich
authors.initials: F
authors.lastname: Knollmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011014:Pneumonia / Q000000981:diagnostic imaging / Q000209:etiology; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods*; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000209:etiology; D036542:Tomography, Spiral Computed / Q000379:methods*