The 100 Top-Cited Articles in Pulmonary Imaging
- Authors
- Hong, Su Jin; Lim, Kyoung Ja; Hwang, Hye Jeon; Seo, Young Lan; Baek, Sora; Yun, Eun Joo; Choi, Chul Soon; Yoon, Dae Young
- Issue Date
- May-2017
- Publisher
- Lippincott Williams & Wilkins Ltd.
- Keywords
- bibliometric analysis; citation; citation classics; pulmonary imaging
- Citation
- Journal of Thoracic Imaging, v.32, no.3, pp.198 - 202
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Thoracic Imaging
- Volume
- 32
- Number
- 3
- Start Page
- 198
- End Page
- 202
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/152369
- DOI
- 10.1097/RTI.0000000000000251
- ISSN
- 0883-5993
- Abstract
- Purpose:
The aim of the study was to compare the accuracies of 4 different methods of assessing pulmonary nodule enhancement to distinguish benign from malignant solid pulmonary nodules using nondynamic contrast-enhanced dual-energy computed tomography.
Materials and Methods:
Seventy-two patients (mean age, 62 y) underwent dual-energy chest computed tomography 3 minutes after intravenous contrast administration. Each of 118 pulmonary nodules (9±5.9 mm) were evaluated for enhancement by 4 methods: visual assessment, 3-dimensional automated postprocessing measurement tool, manually drawn region of interest with calculated iodine-related attenuation, and measurement of iodine concentration. The optimal cutoff for enhancement was defined as having the largest specificity among all cutoffs while maintaining 100% sensitivity. Accuracy of the methods was assessed with receiver operating characteristic curves.
Results:
Ninety-three of 118 pulmonary nodules were benign (79%). Visual assessment of enhancement had sensitivity and specificity of 100% and 44%, respectively. For the automated 3-dimensional measurement tool, 20 HU was found to be the optimal threshold for defining enhancement, resulting in a specificity of 71% and a sensitivity of 100%, as well as an area under the curve (AUC) of 0.87 (95% confidence interval [CI], 0.82-0.92). The AUC was 0.79 (95% CI, 0.73-0.85) for the measured enhancement using a manually drawn region of interest. When a threshold of 21 HU was used for defining enhancement, maximum specificity was obtained (56%) while maintaining 100% sensitivity. The AUC for measured iodine concentration was 0.79 (95% CI, 0.77-0.85). At a cutoff iodine concentration of 0.6 mg/mL, the sensitivity was 100% with a specificity of 57%.
Conclusions:
Although use of automated postprocessing had the highest specificity while maintaining 100% sensitivity, there were only minor clinically relevant differences between measurement techniques given that no single technique misclassified a malignant nodule as nonenhancing.
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