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Detection and quantification of the solid component in pulmonary subsolid nodules by semiautomatic segmentation

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To determine whether semiautomatic volumetric software can differentiate part-solid from nonsolid pulmonary nodules and aid quantification of the solid component.

Methods

As per reference standard, 115 nodules were differentiated into nonsolid and part-solid by two radiologists; disagreements were adjudicated by a third radiologist. The diameters of solid components were measured manually. Semiautomatic volumetric measurements were used to identify and quantify a possible solid component, using different Hounsfield unit (HU) thresholds. The measurements were compared with the reference standard and manual measurements.

Results

The reference standard detected a solid component in 86 nodules. Diagnosis of a solid component by semiautomatic software depended on the threshold chosen. A threshold of −300 HU resulted in the detection of a solid component in 75 nodules with good sensitivity (90 %) and specificity (88 %). At a threshold of −130 HU, semiautomatic measurements of the diameter of the solid component (mean 2.4 mm, SD 2.7 mm) were comparable to manual measurements at the mediastinal window setting (mean 2.3 mm, SD 2.5 mm [p = 0.63]).

Conclusion

Semiautomatic segmentation of subsolid nodules could diagnose part-solid nodules and quantify the solid component similar to human observers. Performance depends on the attenuation segmentation thresholds. This method may prove useful in managing subsolid nodules.

Key Points

• Semiautomatic segmentation can accurately differentiate nonsolid from part-solid pulmonary nodules

• Semiautomatic segmentation can quantify the solid component similar to manual measurements

• Semiautomatic segmentation may aid management of subsolid nodules following Fleischner Society recommendations

• Performance for the segmentation of subsolid nodules depends on the chosen attenuation thresholds

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Acknowledgments

The scientific guarantor of this publication is Prof. W.P.Th.M. Mali. 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. The NELSON study has received funding by Zorg Onderzoek Nederland-Medische Wetenschappen (ZonMw), KWF Kankerbestrijding, Stichting Centraal Fonds Reserves van Voormalig Vrijwillige Ziekenfondsverzekeringen (RvvZ), G. Ph. Verhagen Foundation, Rotterdam Oncologic Thoracic Study Group (ROTS) and Erasmus Trust Fund, Stichting tegen Kanker, Vlaamse Liga tegen Kanker and LOGO Leuven and Hageland. One of the authors has significant statistical expertise and no complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, observational, multicentre study.

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Authors and Affiliations

  1. Department of Radiology, University Medical Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Ernst Th. Scholten, Hester A. Gietema, Willem P. Th.M. Mali & Pim A. de Jong

  2. Department of Radiology, Kennemer Gasthuis, Haarlem, The Netherlands

    Ernst Th. Scholten

  3. Diagnostic Image Analysis Group, Radboud University Medical Center, Nijmegen, The Netherlands

    Colin Jacobs, Bram van Ginneken & Sarah van Riel

  4. Fraunhofer MEVIS, Bremen, Germany

    Bram van Ginneken

  5. Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Rozemarijn Vliegenthart

  6. Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands

    Rozemarijn Vliegenthart & Matthijs Oudkerk

  7. Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands

    Harry J. de Koning & Nanda Horeweg

  8. Department of Pulmonology, Erasmus Medical Center, Rotterdam, The Netherlands

    Nanda Horeweg

  9. Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands

    Mathias Prokop

Authors
  1. Ernst Th. Scholten
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  2. Colin Jacobs
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  3. Bram van Ginneken
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  4. Sarah van Riel
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  5. Rozemarijn Vliegenthart
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  6. Matthijs Oudkerk
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  7. Harry J. de Koning
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  9. Mathias Prokop
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  10. Hester A. Gietema
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  11. Willem P. Th.M. Mali
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  12. Pim A. de Jong
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Corresponding author

Correspondence to Pim A. de Jong.

Additional information

Trial Registration

Dutch-Belgian lung cancer screening trial (NELSON; ISRCTN63545820).

http://www.controlled-trials.com/ISRCTN63545820

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Scholten, E.T., Jacobs, C., van Ginneken, B. et al. Detection and quantification of the solid component in pulmonary subsolid nodules by semiautomatic segmentation. Eur Radiol 25, 488–496 (2015). https://doi.org/10.1007/s00330-014-3427-z

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  • DOI: https://doi.org/10.1007/s00330-014-3427-z

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