Pulmonary nodules: Contrast-enhanced volumetric variation at different CT scan delays.
OBJECTIVE
The purpose of this study was to assess the effects of IV contrast medium and different CT scan delays on volumetric measurements of pulmonary nodule.


METHODS
Automated volumes of 35 pulmonary nodules were calculated with two dedicated software packages (designated as software A and software B) for each unenhanced and contrast-enhanced CT scan at 30-, 60-, 120-, 180-, and 300-second delays (injection protocol, 2 mL/s and 2 mL/kg). Nodule attenuation was also determined. Differences between unenhanced and contrast-enhanced volumes were analyzed by Wilcoxon's signed rank test. Contrast-enhanced volume ratio was calculated as the ratio between contrast-enhanced and unenhanced nodule volume.


RESULTS
Contrast-enhanced volumes were significantly larger than unenhanced volumes (p < 0.05) for all the timing delays except at 30 seconds for software A, and no significant differences were found among volumes measured with both software programs at different contrast-enhanced delays. Median volume ratios between contrast-enhanced and unenhanced volumes were 1.04-1.07 for software A and 1.04-1.06 for software B, and median volume ratios within different contrast-enhanced delays were 0.99-1.03 for software A and 0.99-1.04 for software B. We did not find any significant association between contrast-enhanced volume ratio and nodule diameter, site, shape, unenhanced density, or contrast-enhanced density ratio (p > 0.05).


CONCLUSIONS
We recommend comparing volume of pulmonary nodules obtained from CT examinations only if they are all performed with or without contrast material, whereas nodule volumes obtained by use of enhanced CT performed with different scan delays are comparable.
Rampinelli
Cristiano
C
Department of Radiology, European Institute of Oncology, Milan, Italy. cristiano.rampinelli@ieo.it <cristiano.rampinelli@ieo.it>
Raimondi
Sara
S
Padrenostro
Mauro
M
De Fiori
Elvio
E
Meroni
Stefano
S
Veronesi
Giulia
G
Bellomi
Massimo
M
D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D013902:Radiography, Thoracic / Q000379:methods; D012189:Retrospective Studies; D012984:Software; D003074:Solitary Pulmonary Nodule / Q000473:pathology*; D018709:Statistics, Nonparametric; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; C093233:iobitridol; D007472:Iohexol