Coronal multiplanar reconstruction view from whole lung thin-section CT by multidetector-row CT: determination of malignant or benign lesions and differential diagnosis in 68 cases of solitary pulmonary nodule

PURPOSE: The purpose of this study was to evaluate the usefulness of the coronal multiplanar reconstruction (MPR) view in comparison with transverse helical thin-section CT for both the determination of malignant or benign lesions and the differential diagnosis of solitary pulmonary nodules. MATERIALS AND METHODS: Sixty-eight cases of pathologically proved solitary pulmonary nodule less than 3 cm in diameter were enrolled in this study. For the routine study, transverse helical thin-section CT (1.25 mm collimation, FOV 20 cm) covering the areas with solitary pulmonary nodules as well as whole lung helical thin-section CT (2.5 mm collimation, 1.25 mm reconstruction interval, FOV 34.5 cm, pitch 6:1, high-spatial frequency algorithm) were scanned with a multidetector-row CT (MDCT) scanner. From the whole lung thin-section CT data, coronal MPR views (2.5 mm slice thickness) were reconstructed on a workstation. ROC analysis was used for an observer performance study, in which three observers indicated their confidence level for the determination of malignant or benign lesion for the nodules by means of transverse thin-section CT and coronal MPR. In addition, the observers recorded appropriate disease entities as the final diagnosis of each case. Accuracies of the final diagnosis based on the two sets of images were compared with McNemer' s test. RESULTS: In terms of the determination of malignant or benign lesion, there was no significant difference between the two sets of images (coronal MPR and transverse thin-section CT; mean Az=0.853 and 0.854, respectively). In addition, accuracy of the final diagnosis based on coronal MPR views (74%) was almost equal to that based on transverse thin-section CT (71%) (p=0.3). CONCLUSIONS: The diagnostic efficacy of the coronal MPR view is comparable to that of transverse thin-section CT for the evaluation of solitary pulmonary nodules.