Evaluation of the solitary pulmonary nodule by dynamic spiral CT

William C. Frey*, W. F. Arendt, J. B. Williams, M. J. Morris, J. A. Morgan

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Purpose: To investigate the utility of dynamic spiral CT in the evaluation of a solitary pulmonary nodule (SPN). By measuring maximum contrast enhancement using this modality, the likelihood of malignancy could be predicted. Methods: Any patient with a solitary pulmonary nodule less than 4 cm in diameter and no prior history of cancer was enrolled. All patients underwent a dynamic spiral CT with 2 mm collimation images through the nodule before and after IV contrast. The maximum enhancement of the SPN was measured separately by two radiologists and the change in enhancment was calculated. These findings were compared with the histological or cytological diagnosis obtained by biopsy or surgery. Results: Fourteen patients with SPN in whom a pathological diagnosis was obtained were evaluated. Four patients were found to have a benign process and the remaining ten had a primary pulmonary malignancy. Mean (HU) Range (HU) Benign 23.8 ± 33.2 -13 to 63 Malignant 48.2 ± 58.2 12 to 207 Conclusions: There is a trend demonstrated that malignant lesions tend to show more contrast enhancement than benign lesions. There is no clear delineation to definitively determine absence of malignancy based on dynamic spiral CT alone. Clinical Implications: Further investigation of this modality of imaging is warranted to determine if there is a continuation in the trend and if a specific amount of contrast enhancement suggests the presence of malignancy.

Original languageEnglish
Pages (from-to)305S-306S
Issue number4 SUPPL.
StatePublished - Oct 1998
Externally publishedYes


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