Usefulness of concurrent reading using thin-section and thick-section CT images in subcentimetre solitary pulmonary nodules.
OBJECTIVE
To evaluate the differences in the characterization and recommendation for follow-up of subcentimetre solitary pulmonary nodules (SSPNs) between 5 and 1mm section CT, and to compare the assessments generated by four radiologists


METHODS
Five hundred and twenty-nine patients who had SSPNs on chest CT reconstructed using both 5 and 1mm sections were enrolled. Two image subsets of 5 and 1mm CT images of each nodule were interpreted independently by four radiologists. Nodule size, consistency (solid, partly solid, non-solid), the presence of calcification, and recommendations for follow-up were evaluated. If a non-calcified solid nodule was confirmed using CT, recommendation for follow-up was based on Fleischner Society guidelines. Data assessed by each radiologist were compared, and interobserver agreements were determined using the intraclass correlation coefficients and kappa value.


RESULTS
Using 1mm CT images, the nodule sizes were significantly larger than on 5mm CT images (paired t-test, p<0.01). The presence of calcification and nodule consistency were significantly different between 5 and 1mm CT images (McNemar test for the presence of calcification, p<0.01; Wilcoxon signed test for nodule consistency, p<0.01). On 1mm CT images there was significantly higher agreement regarding nodule consistency than on 5mm CT (kappa=0.78 and 0.67, respectively).


CONCLUSIONS
Concurrent use of thin-section and thick-section CT can provide more accurate nodule assessment and higher interobserver agreement in SSPN.
Lee
H Y
HY
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.
Goo
J M
JM
Lee
H J
HJ
Lee
C H
CH
Park
C M
CM
Park
E-A
EA
Im
J-G
JG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods