Diagnostic accuracy of MIP slice modalities for small pulmonary nodules in paediatric oncology patients revisited: What is additional from the paediatric radiologist approach?

摘要

Background Maximum intensity projection (MIP) CT image reconstruction is a beneficial diagnostic tool in paediatric radiology and can help to distinguish between small pulmonary nodules and adjacent vessels or pulmonary scars. Objectives The purpose of this study was to determine the optimal MIP slice thickness and reconstruction plane for pulmonary nodule detection in paediatric patients. Materials and methods Fifty-five paediatric patients with suspected nodules less than 5 mm who were diagnosed with extra-pulmonary malignancy and underwent multidetector computed tomography (MDCT) of the thorax were evaluated. Multiplanar CT 5 mm MIP reconstruction (axial-coronal-sagittal), 2 mm axial-coronal MIPs, and 1-mm and 5-mm axial source slices, were interpreted independently by three blinded radiologists. The axial -1 mm slices were accepted as the gold standard method as the result of retrospective consensus session in order to get comparison with similar studies. The number of nodules, size and location, distance from pleura, overall time taken and confidence were recorded separately for each observer. Results Receiver operating characteristic (ROC) analysis showed significant advantages of MIP images over averaged images. With high significance (p 0.001), coronal 5 mm MIP reconstructions were found to be most advantageous over conventional reconstruction techniques. Mean reading time was fastest in axial 5 mm MIP images. Conclusions Compared to conventional paediatric chest CT reconstruction techniques, detection of pulmonary nodules with diameters smaller than 5 mm was found to be most sensitive in 5 mm coronal MIP images. Diagnostic accuracy of MIP slice modalities for small pulmonary nodules in paediatric oncology patients revisited: What is additional from the paediatric radiologist approach?