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DOI: 10.1148/radiol.2432052052
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(Radiology 2007;243:561-569.)
© RSNA, 2007

Thoracic Imaging

Pulmonary Nodules: Sensitivity of Maximum Intensity Projection versus That of Volume Rendering of 3D Multidetector CT Data1

Philipp Peloschek, MD, Johannes Sailer, MD, Michael Weber, MSc, Christian J. Herold, MD, Mathias Prokop, MD, and Cornelia Schaefer-Prokop, MD

1 From the Department of Radiology, Vienna Medical University, Währinger Gürtel 18-20, A-1090 Vienna, Austria (P.P., J.S., M.W., C.J.H.); Department of Radiology, Utrecht Medical Center, Utrecht, the Netherlands (M.P.); and Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (C.S.). Received December 16, 2005; revision requested February 10, 2006; revision received May 30; accepted June 20; final version accepted September 5. Supported by grant P17083-N04 from the Austrian Funds for Scientific Research. Address correspondence to P.P. (e-mail: philipp.peloschek{at}meduniwien.ac.at).

Purpose: To prospectively compare maximum intensity projection (MIP) and volume rendering (VR) of multidetector computed tomographic (CT) data for the detection of small intrapulmonary nodules.

Materials and Methods: This institutional review board–approved prospective study included 20 oncology patients (eight women and 12 men; mean age, 56 years ± 16 [standard deviation]) who underwent clinically indicated standard-dose thoracic multidetector CT and provided informed consent. Transverse thin slabs of the chest (thickness, 7 mm; reconstruction increment, 3.5 mm) were created by using MIP and VR techniques to reconstruct CT data (collimation, 16 x 0.75 mm) and were reviewed in interactive cine mode. Mean, minimum, and maximum reading time per examination and per radiologist was documented. Three radiologists digitally annotated all nodules seen in a way that clearly determined their locations. The maximum number of nodules detected by the three observers and confirmed by consensus served as the reference standard. Descriptive statistics were calculated, with P < .05 indicating a significant difference. The Wilcoxon matched-pairs signed rank test and confidence intervals for differences between methods were used to compare the sensitivities of the two methods.

Results: VR performed significantly better than MIP with regard to both detection rate (P < .001) and reporting time (P < .001). The superiority of VR was significant for all three observers and for nodules smaller than 11 mm in diameter and was pronounced for perihilar nodules (P = .023). Sensitivities achieved with VR ranged from 76.5% to 97.3%, depending on nodule size.

Conclusion: VR is the superior reading method compared with MIP for the detection of small solid intrapulmonary nodules.

© RSNA, 2007




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