European Radiology

, Volume 17, Issue 12, pp 3148–3156 | Cite as

Pulmonary nodule detection on MDCT images: evaluation of diagnostic performance using thin axial images, maximum intensity projections, and computer-assisted detection

  • A. JankowskiEmail author
  • T. Martinelli
  • J. F. Timsit
  • C. Brambilla
  • F. Thony
  • M. Coulomb
  • G. Ferretti


This study aimed at evaluating the diagnostic benefits of maximum intensity projections (MIP) and a commercially available computed-assisted detection system (CAD) for the detection of pulmonary nodules on MDCT as compared with standard 1-mm images on lung cancer screening material. Thirty subjects were randomly selected from our database. Three radiologists independently reviewed three types of images: axial 1-mm images, axial MIP slabs, and CAD system detections. Two independent experienced chest radiologists decided which were true-positive nodules. Two hundred eighty-five nodules ≥1 mm were identified as true-positive by consensus of two independent chest radiologists. The detection rates of the three independent observers with 1-mm axial images were 22 ± 4.8%, 30 ± 5.3%, and 47 ± 2.8%; with MIP: 33 ± 5.4%, 39 ± 5.7%, and 45 ± 5.8%; and with CAD: 35 ± 5.6%, 36 ± 5.6%, and 36 ± 5.6%. There was a reading technique effect on the observers’ sensitivity for nodule detection: sensitivities with MIP were higher than with 1-mm images or CAD for all nodules (F-values = 0.046). For nodules ≥3 mm, readers’ sensitivities were higher with 1-mm images or MIP than with CAD (p < 0.0001). CAD was the most and MIP the less time-consuming technique (p < 0.0001). MIP and CAD reduced the number of overlooked small nodules. As MIP is more sensitive and less time consuming than the CAD we used, we recommend viewing MIP and 1-mm images for the detection of pulmonary nodules.


Multislice computed tomography Computer-aided diagnosis Maximum intensity projection (MIP) Pulmonary nodules 


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • A. Jankowski
    • 1
    Email author
  • T. Martinelli
    • 1
  • J. F. Timsit
    • 2
    • 3
  • C. Brambilla
    • 3
    • 4
  • F. Thony
    • 1
  • M. Coulomb
    • 1
  • G. Ferretti
    • 1
    • 3
  1. 1.Service Central de Radiologie et d’Imagerie MédicaleGrenoble Cedex 09France
  2. 2.Réanimation médicale et soins intensifs d’urgenceGrenoble Cedex 09France
  3. 3.INSERM U 823, Institut Albert Bonnot, Rond-point de la ChantourneLa Tronche CedexFrance
  4. 4.Pneumologie, Département de Médecine aigue spécialiséeGrenoble Cedex 09France

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