|
|
|
| Diagnostic value of low-dose spiral CT scans for benign and malignant pulmonary nodules |
| CHEN Suo, JIANG Heli, XU Jiang |
| Department of Medical Imaging, Ningguo Municipal People’s Hospital, Ningguo 242300 China |
|
|
|
|
Abstract Objective To compare the value of low-dose spiral CT and conventional-dose CT for diagnosis of benign and malignant pulmonary nodules, so as to provide a reference for early screening of lung cancer. Methods A total of 288 patients diagnosed with pulmonary nodules in Ningguo Municipal People’s Hospital during the period from January 2019 to August 2023 were enrolled, and all patients underwent low-dose chest spiral CT and conventional-dose CT scans. The pathological biopsy of pulmonary nodules served as a gold standard. The sensitivity, specificity, and accuracy of low-dose spiral CT and conventional-dose CT for diagnosis of benign and malignant pulmonary nodules and the detection rates of vascular aggregation sign, pleural indentation sign, lobulation sign, and spiculation sign were compared. Results The 288 patients with pulmonary nodules included 186 men and 102 women, with a mean age of 61.12 ± 8.34 years. Among these patients, 218 had benign pulmonary nodules and 70 had malignant pulmonary nodules. There were no significant differences between patients with benign and malignant pulmonary nodules in terms of sex, mean age, and the size, location, and characteristics of pulmonary nodules (all P values > 0.05). However, significant differences were observed in terms of changes in pulmonary nodule size, history of smoking, history of pulmonary infections, and family history of cancers (all P values < 0.05). With pathological biopsy of pulmonary nodules as a gold standard, the sensitivity, specificity, and accuracy of conventional-dose CT and low-dose spiral CT for diagnosis of benign and malignant pulmonary nodules were 94.29% and 92.86%, 93.57% and 92.20%, and 93.75% and 92.36%, respectively, with no significant differences (χ2 = 1.975, 1.012, and 1.911, all P values > 0.05). There was no significant difference in the area under the receiver operating characteristic curve between conventional-dose CT and low-dose spiral CT (0.937 vs. 0.921; t = 1.021, P > 0.05). The detection rates of vascular aggregation sign, pleural indentation sign, lobulation sign, and spiculation sign were 20.49% and 19.79%, 23.26% and 22.57%, 37.50% and 35.76%, and 29.17% and 27.43%, respectively, for conventional-dose CT and low-dose spiral CT, with no significant differences (χ2 = 0.171, 0.212, 1.012, and 1.110, all P values > 0.05). Conclusion The diagnostic sensitivity, specificity, and accuracy of benign and malignant pulmonary nodules and the detection rate of pulmonary nodule signs are comparable between conventional-dose CT and low-dose spiral CT. However, low-dose spiral CT has lower radiation dose and higher safety, which deserves extensive applications in early screening for lung cancer.
|
|
Received: 14 March 2024
|
|
|
|
|
|
[1] Li C, Lei SY, Ding L, et al. Global burden and trends of lung cancer incidence and mortality[J]. Chin Med J (Engl), 2023, 136（13）: 1583-1590.
[2] Leiter A, Veluswamy RR, Wisnivesky JP. The global burden of lung cancer: current status and future trends[J]. Nat Rev Clin Oncol, 2023, 20（9）: 624-639.
[3] Thai AA, Solomon BJ, Sequist LV, et al. Lung cancer[J]. Lancet, 2021, 398（10299）: 535-554.
[4] Ning J, Ge T, Jiang ML, et al. Early diagnosis of lung cancer: which is the optimal choice[J]. Aging (Albany NY), 2021, 13（4）: 6214-6227.
[5] Mazzone PJ, Lam L. Evaluating the patient with a pulmonary nodule: a review[J]. JAMA, 2022, 327（3）: 264-273.
[6] Larici AR, Farchione A, Franchi P, et al. Lung nodules: size still matters[J]. Eur Respir Rev, 2017, 26（146）: 170025.
[7] Miller JC, Shepard JAO, Lanuti M, et al. Evaluating pulmonary nodules[J]. J Am Coll Radiol, 2007, 4（6）: 422-426.
[8] Zhou C, Li G, Zhang LY. Spiral CT image characteristics and differential diagnosis secondary pulmonary tuberculosis and lung cancer based on visual sensors[J]. Biomed Res Int, 2022, 2022: 7514898.
[9] Rampinelli C, Origgi D, Bellomi M. Low-dose CT: technique, reading methods and image interpretation[J]. Cancer Imaging, 2012, 12（3）: 548-556.
[10] Balata H, Evison M, Sharman A, et al. CT screening for lung cancer: are we ready to implement in Europe[J]. Lung Cancer, 2019, 134: 25-33.
[11] Hoffman RM, Atallah RP, Struble RD, et al. Lung cancer screening with low-dose CT: a meta-analysis[J]. J Gen Intern Med, 2020, 35（10）: 3015-3025.
[12] Au-Yong ITH, Hamilton W, Rawlinson J, et al. Pulmonary nodules[J]. BMJ, 2020, 371: m3673.
[13] Wu Z, Wang F, Cao W, et al. Lung cancer risk prediction models based on pulmonary nodules: a systematic review[J]. Thorac Cancer, 2022, 13（5）: 664-677.
[14] Imhof H, Schibany N, Ba-Ssalamah A, et al. Spiral CT and radiation dose[J]. Eur J Radiol, 2003, 47（1）: 29-37.
[15] Wu Z, Huang ZF, Qin Y, et al. Progress in three-dimensional computed tomography reconstruction in anatomic pulmonary segmentectomy[J]. Thorac Cancer, 2022, 13（13）: 1881-1887.
[16] Liu HT, Yao X, Xu BQ, et al. Efficacy and safety analysis of multislice spiral CT-guided transthoracic lung biopsy in the diagnosis of pulmonary nodules of different sizes[J]. Comput Math Methods Med, 2022, 2022: 8192832.
[17] 刘燕娜, 莫科, 刘成金. 多层螺旋CT和HRCT诊断孤立性肺结节的价值分析[J]. 现代医用影像学, 2023, 32(3): 462-464. DOI: 10.3969/j.issn.1006-7035.2023.03.017.
Liu YN, Mo K, Liu CJ. Diagnostic value of multislice spiral CT and high-resolution CT for isolated pumonary nodules[J]. Mod Med Imageol, 2023, 32(3): 462-464. DOI: 10.3969/j.issn.1006-7035.2023.03.017.
[18] 张超. 多层螺旋CT和HRCT诊断孤立性肺结节的价值分析[J]. 临床研究，2023，31（10）：142-144.
Zhang C. Diagnostic value of multi-slice spiral CT and HRCT in isolated pulmonary nodules[J]. Clin Res, 2023, 31（10）: 142-144.
[19] 陈晓兵. 多层螺旋CT胸部低剂量扫描对肺结节的鉴别诊断分析[J]. 中国社区医师，2021，37（2）：118-119.
Chen XB. Differential diagnosis of pulmonary nodules by multi-slice spiral CT low dose chest scan[J]. Chin Community Doctors, 2021, 37（2）: 118-119.
[20] 石云珍. 多层螺旋CT胸部低剂量扫描诊断肺结节的应用价值分析[J]. 影像研究与医学应用, 2024, 8(2): 91-93. DOI: 10.3969/j.issn.2096-3807.2024.02.029.
Shi YZ. Application value of low-dose chest multislice CT scan for diagnosis of pulmonary nodules[J]. J Imaging Res Med Appl, 2024, 8(2): 91-93. DOI: 10.3969/j.issn.2096-3807.2024.02.029.
[21] 徐思思. 多层螺旋CT胸部低剂量扫描在肺结节中的诊断效果[J]. 影像研究与医学应用, 2022, 6(18): 133-135. DOI: 10.3969/j.issn.2096-3807.2022.18.045.
Xu SS. Diagnostic efficacy of low-dose chest multislice CT scan for diagnosis of pulmonary nodules[J]. J Imaging Res Med Appl, 2022, 6(18): 133-135. DOI: 10.3969/j.issn.2096-3807.2022.18.045.
[22] Zheng CQ, Wang HF, Liu QZ, et al. Application effect of low-dose spiral CT on pulmonary nodules and its diagnostic value for benign and malignant nodules[J]. Am J Transl Res, 2023, 15（1）: 256-263.
|
| [1] |
ZHOU Lijuan, WEN Yongcang, ZHANG Gensheng, SHI Wei, XIE Youyang, ZHANG Quancheng, ZHONG Jingsong, CHU Wei. MRI diagnosis of spinal epidural lipomatosis in high-altitude areas[J]. Chinese Journal of Radiological Health, 2024, 33(4): 435-439,446. |
|
|
|
|
