title: Low-dose volume perfusion computed tomography (VPCT) for diagnosis of solitary pulmonary nodules.
abstract: OBJECTIVE
  To characterize solitary pulmonary nodules (SPN) in terms of perfusion parameters using low-dose volume perfusion computed tomography (VPCT) and two different calculation methods, compare their results, look for interobserver agreement of measurements and investigate the feasibility of low-dose VPCT.
  
  
  METHODS
  This study was approved by the local Institutional Review Board and all patients provided written informed consent. Seventy-one patients (mean age 60.8 years ±9.6) with solitary pulmonary nodules were enrolled. Low-dose VPCT was performed for 38.63s covering the involved lung (70kV, 120mAs, 22 consecutive volume measurements, 50mL iodinated contrast, flow rate 4mL/s). Mean blood flow (BF), blood volume (BV) and k-trans were determined both with the maximum slope+Patlak vs. deconvolution method. Additionally, the difference of VPCT parameters between different type lesions and normal tissue was analyzed. Interobserver agreement for all perfusion parameters was calculated using intraclass correlation coefficients (ICC). The effective radiation dose of the VPCT and the total CT scan protocol were recorded. All CT findings were histologically confirmed by surgical intervention.
  
  
  RESULTS
  The mean lesion size was 18.6mm. Interobserver agreement measure with ICC shows high agreement between the measurements (κ=0.85). The effective radiation dose of the VPCT was 9.3mSv. The mean perfusion values for BF, BV and k-trans of 120.6mL/100g tissue/', 11.6mL/100g tissue/', and 18.5mL/100g tissue/' for the deconvolution method, and 50.1mL/100g tissue/', 11.6mL/100g tissue/' and 24.3mL/100g tissue/' for the maximum slope+Patlak method, which were significantly higher than those of normal muscle (20.7mL/100g tissue/', 2.6mL/100g tissue/', and 7.6mL/100g tissue/' for the deconvolution method and 10.9mL/100g tissue/', 3.1mL/100g tissue/' and 8.1mL/100g tissue/' for the maximum slope method). The best overall correlation between calculation methods was achieved for measurements of BF.
  
  
  CONCLUSIONS
  The low-dose volume perfusion CT of the solitary pulmonary nodules can effectively reduce the radiation dose and non-invasively assess perfusion of SPN within the entire lesion volume.
authors.affiliation: Department of Radiology, Huadong Hospital affiliated to Fudan University, No. 221 Yan-an Road (West), Shanghai, China.
authors.forename: Yibo
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Thoracic Surgery, Huadong Hospital affiliated to Fudan University, No. 221 Yan-an Road (West), Shanghai, China.
authors.forename: Minjie
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Radiology, Huadong Hospital affiliated to Fudan University, No. 221 Yan-an Road (West), Shanghai, China.
authors.forename: Dingbiao
authors.initials: D
authors.lastname: Mao
authors.affiliation: Department of Thoracic Surgery, Huadong Hospital affiliated to Fudan University, No. 221 Yan-an Road (West), Shanghai, China.
authors.forename: Fanzhen
authors.initials: F
authors.lastname: Lv
authors.affiliation: Department of Pathology, Huadong Hospital affiliated to Fudan University, No. 221 Yan-an Road (West), Shanghai, China.
authors.forename: Yulei
authors.initials: Y
authors.lastname: Yin
authors.affiliation: Department of Radiology, Huadong Hospital affiliated to Fudan University, No. 221 Yan-an Road (West), Shanghai, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Radiology, Huadong Hospital affiliated to Fudan University, No. 221 Yan-an Road (West), Shanghai, China. Electronic address: cjr_huayanqing@163.com.
authors.forename: Yanqing
authors.initials: Y
authors.lastname: Hua
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007479:Iopamidol; D008168:Lung / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D007479:Iopamidol
keywords: Clinical practice; Computed tomography; Low dose; Perfusion; Radiation dose; Solitary pulmonary nodules