CT Densitometry of Lung Mass: The Effect of Reconstruction Algorithm

ABSTRACT

PURPOSE: To evaluate the effect of reconstruction algorithms on the CT measurement of mean lung mass density and normal thoracic structures. MATERIALS AND METHODS: Forty-six patients with a 2-9cm-sized lung mass underwent thoracic CT examinations with intravenous contrast enhancement and using a CT HiSpeed Advantage scanner (GE Medical Systems). In each examination, the axial image of the lung mass was reconstructed using soft, standard, detail, and bone algorithms. The mean value and standard deviation of mass density in Hounsfield Units (HU) were measured using ROIs of three different sizes (50 mm2, 200 mm2, and 350 mm2 or more), and the same method was used to measure the density of normal lung, muscle, bone, and vessels. In 21 patients, mass density was also measured on unenhanced and delayed enhanced images and the degree of enhancement was calculated. RESULTS: The average maximum difference in mean mass density in the images of the four different algorithms was less than 1 (range, 0.1 -1.9) HU (ROI size, 350 mm2 or more), 0 -4.2 HU (200 mm 2), and 0.1 -3.6 HU (50mm2). The average maximum difference in the degree of lung mass enhancement was 0.5 -1.2 (range, 0 -1.6 )HU (ROI size, 350 mm2 or more). The mean density of the four normal thoracic structures was highest in images reconstructed with the bone algorithm, though there was no significant difference between the four different algorithms (p = 1.000). CONCLUSION: The measured mean CT density of a lung mass larger than 2 cm does not significantly change according to the reconstruction algorithm used. When using a small ROI, however, the density difference may increase.