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Changes in quantitative parameters of pulmonary nonsolid nodule induced by lung inflation according to paired inspiratory and expiratory computed tomography imaging

  • Li Fan
  • QingChu Li
  • WenTing Tu
  • RuTan Chen
  • Yi Xia
  • Yu Pu
  • ZhaoBin LiEmail author
  • ShiYuan LiuEmail author
Chest
  • 25 Downloads

Abstract

Objective

To evaluate quantitative parameters of nonsolid nodules on paired inspiratory and expiratory computed tomography (CT) and to examine whether these parameters are sensitive to lung inflation reflected by lung volume.

Methods

Thirty-three patients with 41 nonsolid nodules were included in this prospective study. Paired inspiratory and low-dose respiratory plain chest CT were performed. The volume and density of nonsolid nodule(s), both lungs, the right and left lung, and five lobes, were analyzed in inspiratory and expiratory CT scans. The ratio of expiratory to inspiratory parameters was calculated and labeled as parameter(E-I)/I. To standardize the changes in nonsolid nodule quantitative parameters, the ratio of nonsolid nodule parameter to lung parameter was also calculated. Quantitative parameters were compared between inspiratory and expiratory CT.

Results

Nonsolid nodule volumes on expiratory CT were reduced by 19.8% ± 12.9%, while the density was increased by 11.4% ± 8.8%. The volume of nonsolid nodules was significantly greater on inspiratory compared with expiratory CT (p < 0.001). The density of nonsolid nodules was significantly greater on expiratory than inspiratory CT (p < 0.001). The volume(E-I)/I was significantly greater than density(E-I)/I both in nonsolid nodules and lung. The volume(E-I)/I and density(E-I)/I of nonsolid nodules were independent of size. The density(E-I)/I of nonsolid nodule was greater in the lower lobe than that in the upper lobe (p = 0.002).

Conclusion

Volume changes in nonsolid nodules were more sensitive than density changes in expiratory phase. The density of lower lobe nodules was more susceptible to respiration. Expiratory scanning is not recommended for quantification of nonsolid nodules and/or follow-up.

Key Points

• The nonsolid nodule volume on expiratory CT was reduced by 19.8% ± 12.9%.

• The nonsolid nodule density on expiratory CT was increased by 11.4% ± 8.8%.

• The volume (E-I)/I and density (E-I)/I of nonsolid nodules were independent of size.

Keywords

Solitary pulmonary nodule Tomography, x-ray computed Computational biology 

Abbreviations

AEC

Automatic exposure control

CT

Computed tomography

IL

Ipsilateral lung

MLD

Mean lung density

Parameter(E-I)/I

(Parameterexpiratory−Parameterinspiratory)/Parameterinspiratory

Notes

Funding

This study has received funding by the National Key R&D Program of China (grant numbers 2016YFE0103000 and 2017YFC1308703), the National Natural Science Foundation of China (grant Numbers 81871321 and 81370035), and the Youth Fund of the National Natural Science Foundation of China (grant number 81501618).

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Prof. ShiYuan Liu.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• experimental

• performed at one institution

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Department of Radiology, Changzheng HospitalSecond Military Medical UniversityShanghaiChina
  2. 2.Department of Radiation OncologyShanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghaiChina

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