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Effect of Blood Vessels on Measurement of Nodule Volume in a Chest Phantom¹

¹ From the Thoracic Division, Department of Radiology, New York University Medical Center, 560 First Ave, New York, NY 10016. Received August 21, 2004; revision requested October 28; revision received January 28, 2005; accepted February 28; final version accepted June 13. Supported in part by a Scholars Award from the RSNA Research and Education Foundation, the Society of Thoracic Radiology, and NIH 1 K23 CA096604-01A1. Address correspondence to J.P.K. (e-mail: jane.ko{at}nyumc.org).

Purpose: To identify, by using a chest phantom, whether vessels that contact lung nodules measuring less than 5 mm in diameter will affect nodule volume assessment.

Materials and Methods: Forty synthetic nodules (20 with ground-glass attenuation and 20 with solid attenuation) that measured less than 5 mm in diameter were placed into a chest phantom either adjacent to (n = 30) or isolated from (n = 10) synthetic vessels. Nodules were imaged by using low-dose (20 mAs) and diagnostic (120 mAs) multi–detector row computed tomography (CT). Nodules that were known to lie in direct contact with vessels were confirmed by visual inspection. Nontargeted 1.25 x 1.00-mm sections were analyzed with a three-dimensional computer-assisted method for measuring nodule volume. A mixed-model analysis of variance was used to examine the influence of several factors (eg, the presence of adjacent vessels; tube current–time product; and nodule attenuation, diameter, and location) on measurement error.

Results: The mean absolute error (MAE) for all nodules adjacent to vessels was 2.3 mm³, which was higher than the MAE for isolated nodules (1.9 mm³) (P < .001). This difference proved significant only for diagnostic CT (2.2 mm³ for nodules adjacent to vessels vs 1.3 mm³ for nodules isolated from vessels) (P < .05). A larger MAE was noted for nodules with ground-glass attenuation (2.3 mm³) versus those with solid attenuation (2.0 mm³), for increasing nodule volume (1.66 mm³ for nodules smaller than 20 mm³ vs 2.83 mm³ for nodules larger than 40 mm³), and for posterior nodule location (P < .05).

Conclusion: The presence of a vessel led to a small yet significant increase in volume error on diagnostic-quality images. This represents less than one-third of the overall error, even for nodules larger than 40 mm³ or approximately 4 mm in diameter. This increase, however, may be more important for smaller nodules with errors of less than 3 mm³.

© RSNA, 2006

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