European Radiology

, Volume 15, Issue 1, pp 14–22 | Cite as

Detection of pulmonary nodules at multirow-detector CT: effectiveness of double reading to improve sensitivity at standard-dose and low-dose chest CT

  • Dag Wormanns
  • Karl Ludwig
  • Florian Beyer
  • Walter Heindel
  • Stefan Diederich


The purpose of this study was to assess the effectiveness of double reading to increase the sensitivity of lung nodule detection at standard-dose (SDCT) and low-dose multirow-detector CT (LDCT). SDCT (100 mAs effective tube current) and LDCT (20 mAs) of nine patients with pulmonary metastases were obtained within 5 min using four-row detector CT. Softcopy images reconstructed with 5-mm slice thickness were read by three radiologists independently. Images with 1.25-mm slice thickness served as the gold standard. Sensitivity was assessed for single readers and combinations. The effectiveness of double reading was expressed as the increase of sensitivity. Average sensitivity for detection of 390 nodules (size 3.9±3.2 mm) for single readers was 0.63 (SDCT) and 0.64 (LDCT). Double reading significantly increased sensitivity to 0.74 and 0.79, respectively. No significant difference between sensitivity at SDCT and LDCT was observed. The percentage of nodules detected by all three readers concordantly was 52% for SDCT and 47% for LDCT. Although double reading increased the detection rate of pulmonary nodules from 63% to 74–79%, a considerable proportion of nodules remained undetected. No difference between sensitivities at LDCT and SDCT for detection of small nodules was observed.


Computed tomography Pulmonary nodule Sensitivity 



The authors would like to express their thanks to Robert Kralemann for his support in the practical realization of the study and for entering the data into the computer system.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Dag Wormanns
    • 1
  • Karl Ludwig
    • 1
    • 2
  • Florian Beyer
    • 1
  • Walter Heindel
    • 1
  • Stefan Diederich
    • 1
    • 3
  1. 1.Department of Clinical RadiologyUniversity Hospital MünsterMünsterGermany
  2. 2.Section Diagnostic Radiology, Department of OrthopedicsUniversity of HeidelbergHeidelbergGermany
  3. 3.Department of Diagnostic and Interventional RadiologyMarien-Hospital DüsseldorfDüsseldorfGermany

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