Pulmonary nodules: Assessing the imaging biomarkers of malignancy in a "coffee-break". Issue 101 (April 2018)

• Record Type: Journal Article
• Authors: Talwar, A.; Willaime, J.M.Y.; Pickup, L.C.; Enescu, M.; Boukerroui, D.; Hickes, W; Rahman, N.M.; Gooding, M.J.; Kadir, T.; Gleeson, F.V.
• Is Part Of: European journal of radiology. Issue 101(2018)
• Page Start: 82
• Page End: 86
• Publication Date: 2018-04
• Subjects: Pulmonary nodules -- Lung cancer -- CT -- CT texture analysis -- Radiomics; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2018.02.004
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Introduction: Although nodule volumetry is a recognized biomarker of malignancy in pulmonary nodules (PNs), caution is needed in its interpretation because of variables such as respiratory volume variation and inter-scan variability of up to 25%. CT Texture Analysis (CTTA) is a potential independent biomarker of malignancy but inter-scan variability and respiratory volume variation has not been assessed. Methods: In this prospective cohort study, 40 patients (20 with an indeterminate PN and 20 with pulmonary metastases) underwent two LDCTs within a 60-min period (the "Coffee-break") with the aim of assessing the repeatability of CTTA and semi-automated volume measurements. Texture features were extracted from each automatic contoured region surrounding the PN. Patients were also randomized to two inspiratory control groups: normal breath hold, and controlled lung volume to study the influence of inspiratory control on these measurements. Results: The mean difference in volume between the two scans was 6.3%, SD:29.9%. The textural features displayed 95% CI below ±17.8%, and were less variable than nodule volume (95%CI ± 28.9%). All features had high repeatability, calculated by the concordance correlation coefficient, (0.84 ≤ CCC ≤ 0.99). All measurements were more repeatable for the controlled lung volume group than the normal breath-hold group. Conclusion: CTTA repeatability was comparable to automatic volumetric measurements, and appears to be improved using controlled volume breath holding.