Characterization of solitary pulmonary nodules: Use of washout characteristics at contrast-enhanced computed tomography

Ye,Xiao-Dan; Ye,Jian-Ding; Yuan,Zheng; Dong,Sheng; Xiao,Xiang-Sheng

doi:10.3892/ol.2011.520

Characterization of solitary pulmonary nodules: Use of washout characteristics at contrast-enhanced computed tomography

Authors:
- Xiao-Dan Ye
- Jian-Ding Ye
- Zheng Yuan
- Sheng Dong
- Xiang-Sheng Xiao
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Affiliations: Department of Radiology, Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200030, P.R. China, Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China, Department of Radiology, Affiliated Changzheng Hospital, The Second Military Medical University, Shanghai 200003, P.R. China
Published online on: December 12, 2011 https://doi.org/10.3892/ol.2011.520
Pages: 672-676

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Abstract

The purpose of this study was to determine whether computed tomographic scans and attenuation measurements on contrast material‑enhanced and non-enhanced computed tomographic scans could be used to characterize solitary pulmonary nodules and, in particular, to characterize these lesions using washout characteristics on contrast-enhanced computed tomography. A total of 63 patients (38 males, 25 females; age range, 21-80 years; mean age, 58±13.2 years) with pulmonary nodules revealed on contrast-enhanced computed tomography underwent 20-min delayed enhanced scans. The mean diameter of the pulmonary nodules was 1.8±0.6 cm (range, 0.8‑2.9). Region-of-interest measurements were obtained at non‑enhanced, dynamic enhanced and delayed enhanced computed tomography and were used to calculate a relative percentage washout as follows: 1 ‑ (Hounsfield unit measurement on delayed image/Hounsfield unit measurement on dynamic image) x 100%. There was a mean relative washout of 33% on the delayed computed tomographic scans (range, 12‑46) in benign solitary pulmonary nodules; and a mean relative washout of 7% (range, -36‑51) in malignant solitary pulmonary nodules (Mann-Whitney U test, p<0.001). Results of the receiver operating curve analysis revealed that a threshold relative washout of 14.5% had 74.3% sensitivity and 92.9% specificity for identifying malignant nodules. Calculation of the relative percentage washout on dynamic and delayed enhanced computed tomographic scans may lead to a highly specific test for solitary pulmonary nodule characterization and reduce the need for, and possibly obviate, follow-up imaging or biopsy.

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