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Original research article


Rationale of Using Dynamic Imaging for Characterization of Suspicious Lung Masses into Benign or Malignant on Contrast Enhanced Multi Detector Computed Tomography.

Sachin KhanduriSaurav BhagatParul ShokeenGirjesh KumarShobha KhanduriBhumika Singh
Department of Radiodiagnosis, Era’s Lucknow Medical College and HospitalDepartment of Histopathology and Lab Operations, SRL Diagnostic Laboratory, Lucknow, Uttar Pradesh, India
Date of Submission: 27-Feb-2017, Date of Acceptance: 05-May-2017, Date of Web Publication: 27-Jun-2017.
Corresponding Author:
Corresponding Author

Saurav Bhagat

Department of Radiodiagnosis, Era’s Lucknow Medical College and Hospital, Sarfarazgunj, Hardoi Road, Lucknow ‑ 226 003, Uttar Pradesh, India.
E-mail: dr.sauravbhagat@gmail.com

Corresponding Author:
Corresponding Author

Saurav Bhagat

Department of Radiodiagnosis, Era’s Lucknow Medical College and Hospital, Sarfarazgunj, Hardoi Road, Lucknow ‑ 226 003, Uttar Pradesh, India.
E-mail: dr.sauravbhagat@gmail.com

DOI: 10.4103/jcis.JCIS_18_17 Facebook Twitter Google Linkedin

ABSTRACT



Objectives: To assess the utility of dynamic imaging namely, wash-in and wash-out characteristics through multidetector contrast-enhanced computed tomography in differentiating benign and malignant pulmonary masses.
Materials and Methods: Seventy-three patients who were suspected to have malignant pulmonary mass on the basis of clinical symptoms and chest radiograph were included in the study. All the patients underwent multidetector computed tomography scanning, and three series of images were obtained for each patient-noncontrast, early enhanced, and 15 min delayed enhanced scans. Computed tomography (CT) findings were assessed in terms of washin, absolute, and relative percentage washout of contrast. Biopsy of the mass was done and sent for histopathological evaluation. Sensitivity, specificity, and area under curve for diagnosing malignancy in the lung masses were calculated by considering both the wash-in and wash-out characteristics at dynamic CT and plotting the receiver operating curve after the final diagnosis which was obtained by histopathological evaluation.
Results: Threshold net enhancement (washin) value of >22.5 HU had sensitivity, specificity, and diagnostic accuracy of 88.5%, 57.1%, and 82%, respectively, in predicting malignancy. Threshold relative percentage washout of <16.235% had 98.1%, 85.7%, and 94% sensitivity, specificity, and diagnostic accuracy, respectively, and threshold absolute percentage washout of <42.72% had 98.1%, 95.2%, and 95% sensitivity, specificity, and diagnostic accuracy, respectively, in predicting malignancy.
Conclusion: Threshold net enhancement (washin), absolute and relative washout percentages can be used to predict malignancy with very high diagnostic yield, and possibly obviate the need of invasive procedures for diagnosis of bronchogenic carcinoma.
Keywords: Contrast Wash-in, Contrast Wash-out, Histopathology, Lung Mass, Multidetector Computed Tomography

Cited in 1 Document

  1. Dominik Deniffel, Andreas Sauter, Julia Dangelmaier, Alexander Fingerle, Ernst J. Rummeny and Daniela Pfeiffer (2019) Differentiating intrapulmonary metastases from different primary tumors via quantitative dual-energy CT based iodine concentration and conventional CT attenuation. European Journal of Radiology 111:6. doi: 10.1016/j.ejrad.2018.12.015

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