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Visual assessment of calcification in solitary pulmonary nodules on chest radiography: correlation with volumetric quantification of calcification

DOI:10.1007/s00330-018-5883-3 期刊:European Radiology 出版年份:2019 更新时间:2025-09-23 15:23:52
摘要: Purpose To assess the ability of digital chest radiography (CXR) to reveal calcification in solitary pulmonary nodules (SPNs), and to examine the correlation between a visual assessment and volumetric quantification of the calcification. Materials and methods This study was a retrospective review of 220 SPNs identified by both CXR and chest CT. Eleven observers did blind review of the CXR images and scored nodule calcification on a confidence scale of 1 to 5. The area under the receiver operating characteristics (ROC) curve (AUC) was obtained to analyze the diagnostic performance. The intraclass correlation coefficient (ICC) for interrater reliability was calculated. The AUC and ICC were calculated according to the following nodule diameter groups: group 1 (< 10 mm), group 2 (≥ 10 mm and < 20 mm), and group 3 (≥ 20 mm). Results Of the 220 SPNs, 145 SPNs (65.6%) were identified as non-calcified and 75 (34.4%) as calcified. The average percentage of calcification volume in SPN > 160 HU (Vol160HU) among the 75 calcified nodules was 47.5%. The mean Vol160HU of the 68 SPNs classified as having definite calcification was 51.1%. The overall AUC was 0.71. The AUCs for groups 1, 2, and 3 was 0.835, 0.639, and 0.620, respectively. The ICCs for groups 1, 2, 3 was 0.65, 0.48, and 0.33, respectively. Conclusion The overall diagnostic performance of digital CXR to predict calcification in SPNs was moderately accurate and the diagnostic performance for predicting calcification in SPNs was significantly higher, and interobserver reproducibility was good when SPN < 10 mm compared with ≥ 10 mm in diameter.
作者: Seulgi You,Eun Young Kim,Kyung Joo Park,Joo Sung Sun
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To assess the ability of digital chest radiography (CXR) to reveal calcification in solitary pulmonary nodules (SPNs), and to examine the correlation between a visual assessment and volumetric quantification of the calcification.

The overall diagnostic performance of digital CXR for predicting calcification in SPNs is moderately accurate, with better performance and reproducibility for nodules <10 mm. SPNs with benign calcification typically have about 50% calcification volume, and visual assessments correlate with this volumetric quantification.

Retrospective nature, uneven distribution of calcified nodules across size groups, predominance of diffuse calcification patterns, need for larger sample sizes for clearer understanding.

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