CT Diagnosis and Management of Focal Lung Disease

  • Ioannis Vlahos
  • Heber MacMahon


The diagnosis of focal pulmonary opacities remains challenging. Compared with chest radiography, computed tomography (CT), supplemented by thin-section or high-resolution CT (HRCT) imaging, enables better determination of the characteristics of individual lesions. Focal opacities can be broadly categorised as nodules, masses scars or focal parenchymal airspace disease.


Invasive Aspergillosis Invasive Adenocarcinoma Atypical Adenomatous Hyperplasia False Positive Detection Rate Subsolid Nodule 


  1. 1.
    Woodring JH, Fried AM, Chuang VP (1980) Solitary cavities of the lung: diagnostic implications of cavity wall thickness. AJR Am J Roentgenol 135:1269–1271PubMedCrossRefGoogle Scholar
  2. 2.
    Honda O, Tsubamoto M, Inoue A et al (2007) Pulmonary cavitary nodules on computed tomography: differentiation of malignancy and benignancy. J Comput Assist Tomogr 31:943–949PubMedCrossRefGoogle Scholar
  3. 3.
    Swensen SJ, Viggiano RW, Midthun DE et al (2000) Lung nodule enhancement at CT: multicenter study. Radiology 214:73–80PubMedGoogle Scholar
  4. 4.
    Chae EJ, Song JW, Seo JB et al (2008) Clinical utility of dual-energy CT in the evaluation of solitary pulmonary nodules: initial experience. Radiology 249:671–681PubMedCrossRefGoogle Scholar
  5. 5.
    Swensen SJ, Jett JR, Hartman TE et al (2005) CT screening for lung cancer: five-year prospective experience. Radiology 235:259–265PubMedCrossRefGoogle Scholar
  6. 6.
    Piyavisetpat N, Aquino SL, Hahn PF et al (2005) Small incidental pulmonary nodules: how useful is short-term interval CT follow-up? J Thorac Imaging 20:5–9PubMedCrossRefGoogle Scholar
  7. 7.
    MacMahon H, Austin JH, Gamsu G et al (2005) Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society. Radiology 237:395–400PubMedCrossRefGoogle Scholar
  8. 8.
    Li F, Aoyama M, Shiraishi J et al (2004) Radiologists’ performance for differentiating benign from malignant lung nodules on high-resolution CT using computer-estimated likelihood of malignancy. AJR Am J Roentgenol 183:1209–1215PubMedCrossRefGoogle Scholar
  9. 9.
    Yankelevitz DF, Reeves AP, Kostis et al (2000) Small pulmonary nodules: volumetrically determined growth rates based on CT evaluation. Radiology 217:251–256PubMedGoogle Scholar
  10. 10.
    Jennings SG, Winer-Muram HT, Tarver RD et al (2004) Lung tumor growth: assessment with CT—comparison of diameter and cross-sectional area with volume measurements. Radiology 231:866–871PubMedCrossRefGoogle Scholar
  11. 11.
    Jennings SG, Winer-Muram HT, Tann M et al (2006) Distribution of stage I lung cancer growth rates determined with serial volumetric CT measurements. Radiology 241:554–563PubMedCrossRefGoogle Scholar
  12. 12.
    Revel MP, Merlin A, Peyrard S et al (2006) Software volumetric evaluation of doubling times for differentiating benign versus malignant pulmonary nodules. AJR Am J Roentgenol 187:135–142PubMedCrossRefGoogle Scholar
  13. 13.
    Honda O, Kawai M, Gyobu T et al (2009) Reproducibility of temporal volume change in CT of lung cancer: comparison of computer software and manual assessment. Br J Radiol 82:742–747PubMedCrossRefGoogle Scholar
  14. 14.
    Boite H, Riedel C, Müller-Hülsbeck S et al (2007) Precision of computer-aided volumetry of artificial small solid pulmonary nodules in ex vivo porcine lungs. Br J Radiol 80:414–421CrossRefGoogle Scholar
  15. 15.
    Henschke CI, Yankelevitz DF, Mirtcheva R et al (2002) CT screening for lung cancer: frequency and significance of part-solid and nonsolid nodules. AJR Am J Roentgenol 178:1053–1057PubMedCrossRefGoogle Scholar
  16. 16.
    Aoki T, Nakata H, Watanabe H et al (2000) Evolution of peripheral lung adenocarcinomas: CT findings correlated with histology and tumor doubling time. AJR Am J Roentgenol 174:763–768PubMedCrossRefGoogle Scholar
  17. 17.
    Noguchi M, Morikawa A, Kawasaki M et al (1995) Small adenocarcinoma of the lung. Histologic characteristics and prognosis. Cancer 75:2844–2852PubMedCrossRefGoogle Scholar
  18. 18.
    Hasegawa, Sone S, Takashima SM et al (2000) Growth rate of small lung cancers detected on mass CT screening. Br J Radiol 73:1252–1259PubMedGoogle Scholar
  19. 19.
    Kodama K, Higashiyama M, Yokouchi H et al (2001) Prognostic value of ground-glass opacity found in small lung adenocarcinoma on high-resolution CT scanning. Lung Cancer 33:17–25PubMedCrossRefGoogle Scholar
  20. 20.
    Higashiyama M, Kodama K, Yokouchi H et al (1999) Prognostic value of bronchiolo-alveolar carcinoma component of small lung adenocarcinoma. Ann Thorac Surg 68:2069–2073PubMedCrossRefGoogle Scholar
  21. 21.
    Godoy MC, Naidich DP (2009) Subsolid pulmonary nodules and the spectrum of peripheral adenocarcinomas of the lung: recommended interim guidelines for assessment and management. Radiology 253:606–622PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • Ioannis Vlahos
    • 1
  • Heber MacMahon
    • 2
  1. 1.St. George’s HospitalLondonUK
  2. 2.University of ChicagoChicagoUSA

Personalised recommendations