Automatic segmentation and identification of solitary pulmonary nodules on follow-up CT scans based on local intensity structure analysis and non-rigid image registration

2011 ◽  
Author(s):  
Bin Chen ◽  
Hideto Naito ◽  
Yoshihiko Nakamura ◽  
Takayuki Kitasaka ◽  
Daniel Rueckert ◽  
...  
Keyword(s):  
Image Registration ◽  
Structure Analysis ◽  
Automatic Segmentation ◽  
Pulmonary Nodules ◽  
Ct Scans ◽  
Solitary Pulmonary Nodules ◽  
Local Intensity

SHOULD WE BE CONCERNED ABOUT THE DOSES OF IONIZING RADIATION RELATED TO DIAGNOSTIC AND FOLLOW-UP IMAGING IN PATIENTS WITH SOLITARY PULMONARY NODULES?

2017 ◽  
Vol 178 (2) ◽  
pp. 201-207 ◽  
Author(s):  
Marta Dąbrowska ◽  
Zuzanna Przybyło ◽  
Małgorzata Żukowska ◽  
Małgorzata Kobylecka ◽  
Marta Maskey-Warzęchowska ◽  
...  
Keyword(s):  
Ionizing Radiation ◽  
Pulmonary Nodules ◽  
Solitary Pulmonary Nodules

scholarly journals Impact of solitary pulmonary nodule size on qualitative and quantitative assessment using 18F-fluorodeoxyglucose PET/CT: the SPUTNIK trial

2020 ◽  
Author(s):  
J. R. Weir-McCall ◽  
◽  
S. Harris ◽  
K. A. Miles ◽  
N. R. Qureshi ◽  
...  
Keyword(s):  
Multicentre Trial ◽  
Pulmonary Nodules ◽  
Blood Pool ◽  
Qualitative Assessment ◽  
Solitary Pulmonary Nodules ◽  
Nodule Size ◽  
Diagnostic Threshold ◽  
Pet Ct ◽  
The Impact

Abstract Purpose To compare qualitative and semi-quantitative PET/CT criteria, and the impact of nodule size on the diagnosis of solitary pulmonary nodules in a prospective multicentre trial. Methods Patients with an SPN on CT ≥ 8 and ≤ 30 mm were recruited to the SPUTNIK trial at 16 sites accredited by the UK PET Core Lab. Qualitative assessment used a five-point ordinal PET-grade compared to the mediastinal blood pool, and a combined PET/CT grade using the CT features. Semi-quantitative measures included SUVmax of the nodule, and as an uptake ratio to the mediastinal blood pool (SURBLOOD) or liver (SURLIVER). The endpoints were diagnosis of lung cancer via biopsy/histology or completion of 2-year follow-up. Impact of nodule size was analysed by comparison between nodule size tertiles. Results Three hundred fifty-five participants completed PET/CT and 2-year follow-up, with 59% (209/355) malignant nodules. The AUCs of the three techniques were SUVmax 0.87 (95% CI 0.83;0.91); SURBLOOD 0.87 (95% CI 0.83; 0.91, p = 0.30 versus SUVmax); and SURLIVER 0.87 (95% CI 0.83; 0.91, p = 0.09 vs. SUVmax). The AUCs for all techniques remained stable across size tertiles (p > 0.1 for difference), although the optimal diagnostic threshold varied by size. For nodules < 12 mm, an SUVmax of 1.75 or visual uptake equal to the mediastinum yielded the highest accuracy. For nodules > 16 mm, an SUVmax ≥ 3.6 or visual PET uptake greater than the mediastinum was the most accurate. Conclusion In this multicentre trial, SUVmax was the most accurate technique for the diagnosis of solitary pulmonary nodules. Diagnostic thresholds should be altered according to nodule size. Trial registration ISRCTN - ISRCTN30784948. ClinicalTrials.gov - NCT02013063

scholarly journals Solid Indeterminate Pulmonary Nodules Less Than or Equal to 250 mm3: Application of the Updated Fleischner Society Guidelines in Clinical Practice

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Andrea Borghesi ◽  
Silvia Michelini ◽  
Giorgio Nocivelli ◽  
Mario Silva ◽  
Alessandra Scrimieri ◽  
...  
Keyword(s):  
Doubling Time ◽  
Pulmonary Nodules ◽  
Chest Ct ◽  
Ct Scans ◽  
Inclusion Criteria ◽  
Histologic Diagnosis ◽  
Indeterminate Nodules ◽  
Risk Patients ◽  
New Guidelines

Background. The latest version of the Fleischner Society guidelines for management of incidental pulmonary nodules was published in 2017. The main purpose of these guidelines is to reduce the number of unnecessary computed tomography (CT) examinations during the follow-up of small indeterminate nodules. Objective. The present study aimed to evaluate the performance of these guidelines for management of solid indeterminate pulmonary nodules (SIPNs) ≤ 250 mm3. Materials and Methods. During a 7-year period, we retrospectively reviewed the chest CT scans of 672 consecutive patients with SIPNs. The study sample was selected according to the following inclusion criteria: solitary SIPN; diameter ≥ 3 mm; volume ≤ 250 mm3; two or more CT scans performed with the same scanner and same acquisition/reconstruction protocol; thin-section 1-mm images in DICOM format; histologic diagnosis or follow-up ≥ 2 years; and no oncological history. Applying these criteria, a total of 27 patients with single SIPNs ≤ 250 mm3 were enrolled. For each SIPN, the volume and doubling time were calculated using semiautomatic software throughout the follow-up period. For each SIPN, we applied the Fleischner Society guidelines, and the recommended management was compared to what was actually done. Results. A significant volumetric increase was detected in 5/27 (18.5%) SIPNs; all growing nodules were observed in high-risk patients. In these SIPNs, a histologic diagnosis of malignancy was obtained. Applying the Fleischner Society recommendations, all five malignant nodules would have been identified. None of the SIPNs < 100 mm3 in low-risk patients showed significant growth during the follow-up period. The application of the new guidelines would have led to a significant reduction in follow-up CT examinations (Hodges-Lehmann median difference, -2 CT scans; p = 0.0001). Conclusion. The application of the updated Fleischner Society guidelines has been shown to be effective in the management of SIPNs ≤ 250 mm3 with a significant reduction in radiation dose.

scholarly journals Accuracy of implementing principles of fusion imaging in the follow up and surveillance of complex aneurysm repair

2018 ◽  
Vol 23 (5) ◽  
pp. 461-466
Author(s):  
Teresa Martin-Gonzalez ◽  
Graeme Penney ◽  
Debra Chong ◽  
Meryl Davis ◽  
Tara M Mastracci
Keyword(s):  
Renal Impairment ◽  
Automatic Segmentation ◽  
Left Kidney ◽  
Intraclass Correlation ◽  
Critical Issue ◽  
Fusion Imaging ◽  
Aortic Aneurysms ◽  
Ct Scans ◽  
Renal Volume

Fusion imaging is standard for the endovascular treatment of complex aortic aneurysms, but its role in follow up has not been explored. A critical issue is renal function deterioration over time. Renal volume has been used as a marker of renal impairment; however, it is not reproducible and remains a complex and resource-intensive procedure. The aim of this study is to determine the accuracy of a fusion-based software to automatically calculate the renal volume changes during follow up. In this study, computerized tomography (CT) scans of 16 patients who underwent complex aortic endovascular repair were analysed. Preoperative, 1-month and 1-year follow-up CT scans have been analysed using a conventional approach of semi-automatic segmentation, and a second approach with automatic segmentation. For each kidney and at each time point the percentage of change in renal volume was calculated using both techniques. After review, volume assessment was feasible for all CT scans. For the left kidney, the intraclass correlation coefficient (ICC) was 0.794 and 0.877 at 1 month and 1 year, respectively. For the right side, the ICC was 0.817 at 1 month and 0.966 at 1 year. The automated technique reliably detected a decrease in renal volume for the eight patients with occluded renal arteries during follow up. This is the first report of a fusion-based algorithm to detect changes in renal volume during postoperative surveillance using an automated process. Using this technique, the standardized assessment of renal volume could be implemented with greater ease and reproducibility and serve as a warning of potential renal impairment.

Estimation of the doses of ionizing radiation related to diagnostic and follow-up imaging in patients with solitary pulmonary nodules

2016 ◽  
Author(s):  
Marta Dabrowska ◽  
Marta Maskey-Warzechowska ◽  
Malgorzata Kobylecka ◽  
Malgorzata Zukowska ◽  
Rafal Krenke
Keyword(s):  
Ionizing Radiation ◽  
Pulmonary Nodules ◽  
Solitary Pulmonary Nodules

Solitary pulmonary nodules (SPNs): Outcome of 6-year follow-up by a VA multidisciplinary lung cancer group.

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. 7073-7073
Author(s):  
H. B. Niell ◽  
J. P. Griffin ◽  
H. Cole ◽  
J. Salazar ◽  
D. Weiman ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pulmonary Nodules ◽  
Solitary Pulmonary Nodules ◽  
Cancer Group

Evaluating pulmonary nodules to detect lung cancer: Does Fleishner criteria really work?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13053-e13053
Author(s):  
Muhammad Azharuddin ◽  
Aamir Malik ◽  
Noor Adamo ◽  
Douglas S Livornese
Keyword(s):  
Lung Cancer ◽  
Pulmonary Nodules ◽  
Smoking History ◽  
Ct Scans ◽  
Screening Methods ◽  
Cancer History ◽  
Entire Cohort ◽  
Risk Of Malignancy ◽  
Small Pulmonary Nodules

e13053 Background: The Fleishner Society recommends interval computed tomography (CT) follow-up for managing incidental small pulmonary nodules detected in CT scans. This study evaluates the clinical application of 2013 Fleishner criteria using a large cohort of patients at high risk for lung cancer with low-dose CT screening. Methods: During 2012-2016, a retrospective study of 176 patients was reviewed for incidental lung nodules. Patient eligibility included: men and women aged 55-74; 30 pack-year smoking history who quit in the last 15 years; no cancer history in the last 5 years; and no previous CT chest scan done. Follow-up and management was calculated using the Fleishner criteria. Nodules were classified based on several features including size and shape. Nodule characteristics were tabulated and analyzed. Results: Out of 176 patients, 117 had nodules and a total of 210 nodules were detected. Table 1 categorizes all nodule features including Fleishner Criteria. Of the entire cohort, two patients (1.1%) showed malignancy: one part-solid nodule of 10.2mm, and one multiple subsolid groundglass nodule (GGN) of 20.1mm. Twenty-one patients (17.9%) had undergone unnecessary follow-up CT scans, including those with solid nodules, and solitary pure GGNs. Conclusions: This study emphasizes the need to revise the Fleishner guidelines to more accurately estimate the risk of malignancy, including minimizing over-diagnosis, unnecessary follow-up CTs, and invasive procedures for benign pulmonary nodules. Further analysis of lung cancer contributory factors is also required. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document