The role of dynamic contrast-enhanced CT in characterization of solitary solid pulmonary nodules

Abstract

BackgroundIncidental indeterminate solitary solid pulmonary nodule is a progressively common finding on CT worldwide. Once detected, there are a number of imaging modalities that can be done to help in nodule characterization and differentiating benign from malignant nodules. Through these imaging modalities, there are PET CT, SPECT and dynamic CE-CT. Dynamic CE-CT is a functional test that help in assessment of the vascularity of the nodule which reverb the degree of angiogenesis of that nodule so can help in differentiating benign from malignant pulmonary nodules. The purpose of this study was to evaluate the role of Dynamic CE-CT in characterization of solitary pulmonary nodules. Detect what are the important parameters on dynamic CE-CT to differentiate benign from malignant nodules and detect their cutoff values.ResultsThe pre-enhancement value shows cutoff point of 26.50 HU with sensitivity 93.8% and specificity 75% with accuracy rate 90% in differentiating benign from malignant pulmonary nodules. Peak enhancement value (at 2 min) shows cutoff point of 40.00 HU with sensitivity 96.9% and specificity 87.5% with accuracy rate 95% in differentiating benign from malignant pulmonary nodules. Net enhancement value shows cutoff point of 19.00 HU with sensitivity 96.9% and specificity 87.5% with accuracy rate 95% in differentiating benign from malignant pulmonary nodules.ConclusionDynamic CE-CT is a useful tool in differentiating benign from malignant pulmonary nodules. Peak and net enhancement values are important parameters with high sensitivity and specificity in differentiating benign from malignant pulmonary nodules.