Objective: To assess volumetric measurement variability in pulmonary nodules detected at low-dose chest CT with three reconstruction settings. Methods: The volume of 200 solid pulmonary nodules was measured three times using commercially available semi-automated software of low-dose chest CT data-sets reconstructed with 1 mm section thickness and a soft kernel (A), 2 mm and a soft kernel (B), and 2 mm and a sharp kernel (C), respectively. Repeatability coefficients of the three measurements within each setting were calculated by the Bland and Altman method. A three-level model was applied to test the impact of reconstruction setting on the measured volume. Results: The repeatability coefficients were 8.9, 22.5 and 37.5% for settings A, B and C. Three-level analysis showed that settings A and C yielded a 1.29 times higher estimate of nodule volume compared with setting B (P=0.03). The significant interaction among setting, nodule location and morphology demonstrated that the effect of the reconstruction setting was different for different types of nodules. Low-dose CT reconstructed with 1 mm section thickness and a soft kernel provided the most repeatable volume measurement. Conclusion: A wide, nodule-type-dependent range of agreement between volume measurements with different reconstruction settings suggests strict consistency is required for serial CT studies.

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doi.org/10.1007/s00330-009-1634-9, hdl.handle.net/1765/28104
European Radiology: journal of the European Congress of Radiology
Erasmus MC: University Medical Center Rotterdam

Wang, C., de Bock, G., van Klaveren, R., van Ooyen, P., Tukker, W., Zhao, Y., … Oudkerk, M. (2010). Volumetric measurement of pulmonary nodules at low-dose chest CT: Effect of reconstruction setting on measurement variability. European Radiology: journal of the European Congress of Radiology, 20(5), 1180–1187. doi:10.1007/s00330-009-1634-9