Reproducibility of volumetric computed tomography of stable small pulmonary nodules with implications on estimated growth rate and optimal scan interval

Gary T. Smith, Ahmad R. Rahman, Ming Li, Brandon Moore, Hester Gietema, Giulia Veronesi, Pierre P. Massion, Ronald C. Walker

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To use clinically measured reproducibility of volumetric CT (vCT) of lung nodules to estimate error in nodule growth rate in order to determine optimal scan interval for patient follow-up. Methods: We performed quantitative vCT on 89 stable non-calcified nodules and 49 calcified nodules measuring 3-13 mm diameter in 71 patients who underwent 3-9 repeat vCT studies for clinical evaluation of pulmonary nodules. Calculated volume standard deviation as a function of mean nodule volume was used to compute error in estimated growth rate. This error was then used to determine the optimal patient follow-up scan interval while fixing the false positive rate at 5%. Results: Linear regression of nodule volume standard deviation versus the mean nodule volume for stable non-calcified nodules yielded a slope of 0.057±0.002 (r2 = 0.79, p2 = 0.65, p = 0.03). Using this with the error propagation formula, the optimal patient follow-up scan interval was calculated to be 81 days, independent of initial nodule volume. Conclusions: Reproducibility of vCT is excellent, and the standard error is proportional to the mean calculated nodule volume for the range of nodules examined. This relationship constrains statistical certainty of vCT calculated doubling times and results in an optimal scan interval that is independent of the initial nodule volume.

Original languageEnglish
Article numbere0138144
JournalPLoS One
Volume10
Issue number9
DOIs
Publication statusPublished - Sep 17 2015

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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