Comparison of Lung Masses Perfusion Characteristics by Dynamic Contrast Enhanced CT with Histopathology: A Cross-sectional StudyCorrespondence Address :
Dr. Sachin Khanduri,
C-149, Indira Nagar, Lucknow-226016, Uttar Pradesh, India.
Introduction: The management of lung masses depends upon the nature of the mass i.e., being benign or malignant. The use of contrast based Computed Tomography (CT) scan helps in ascertaining the malignant nature of the lesion. In previous studies, computed tomographic evaluations are done to evaluate pulmonary nodules, but only few studies characterised the lung masses into benign and malignant lesions.
Aim: To evaluate the diagnostic accuracy of a non invasive modality (dynamic contrast enhanced perfusion CT), in the characterisation of lung masses by comparing with histopathology.
Materials and Methods: A cross-sectional observational study was conducted at a tertiary care center, Lucknow, Uttar Pradesh, India from January 2018 to November 2019 where 62 patients between age group 20 to 80 years of both sexes with lung masses and no contraindications to the administration of iodinated contrast material were enrolled in the study. Dynamic Contrast Enhanced CT (DCE-CT) perfusion was done which included parameters like Blood Flow (BF) in mL/100 g/min, Blood Volume (BV) in mL/100 g, Mean Transit Time (MTT) in seconds, and Flow Extraction Product (FEP) in mL/100 mL/min. The DCE-CT features were compared with histopathology to determine the sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV).
Results: Among the 62 lung mass cases included in the study, 30 were histopathologically found to be benign lesions and 32 were malignant lesions. On contrast enhancement, the values of the CT perfusion parameters among the malignant masses were significantly higher as compared to benign (p<0.001). DCE-CT was able to correctly diagnose 31/32 cases of malignant and 26/30 cases of benign lung masses in concordance with histopathology. Thus, the overall, sensitivity, specificity, PPV, NPV, and diagnostic accuracy was 96.90%, 86.70%, 88.60%, 96.30%, and 91.90%, respectively.
Conclusion: DCE-CT has a high diagnostic value in differentiation of malignant from benign lung masses and thus can be promoted for its use as a non invasive methods for lung masses characterisation.
Benign lung masses, Computed tomography, Malignant lung masses, Pulmonary nodules
Date of Submission: Mar 15, 2021
Date of Peer Review: Jun 05, 2021
Date of Acceptance: Jul 31, 2021
Date of Publishing: Oct 01, 2021
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA
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ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)