Multimodality CT Imaging Contributes to Improving the Diagnostic Accuracy of Solitary Pulmonary Nodules: A Multi-institutional and Prospective Study

Multimodality CT Imaging for Solitary Pulmonary Nodules

Abstract

Background. Solitary pulmonary nodules (SPNs) are one of the most common chest computed tomography (CT) abnormalities clinically. However, there are no publications in the literature in which non-contrast enhanced CT (NECT), contrast enhanced CT (CECT), CT perfusion imaging (CTPI) and dual-energy CT (DECT) were comprehensively used to differentiate benign or malignant SPNs. We aimed to investigate the value of NECT, CECT, CTPI, and DECT used separately or in combination for differentiating benign and malignant SPNs with a multi-institutional and prospective study.

Patients and methods. Patients with 285 SPNs were performed with NECT, CECT, CTPI and DECT. Differences between the benign and malignant SPNs on NECT, CECT, CTPI, and DECT used separately (NECT combined with CECT, DECT, and CTPI were methods of A, B, and C) or in combination (Method A + B, A + C, B + C, and A + B + C) were compared, as appropriate. Results. Multimodality CT imaging showed higher performances (sensitivities of 92.81 % to 97.60 %, specificities of 74.58 % to 88.14 %, and accuracies of 86.32 % to 93.68 %) than those of single modality CT imaging (sensitivities of 83.23 % to 85.63 %, specificities of 63.56 % to 67.80 %, and accuracies of 75.09 % to 78.25 %, all p < 0.05).

Conclusion. SPNs evaluated with multimodality CT imaging contributes to improving the diagnostic accuracy of benign and malignant SPNs. NECT and CECT helps to evaluate the morphology and vascularity of a nodule, and CTPI and DECT are useful in providing some detailed information.