Diagnostic value of low-dose spiral CT scans for benign and malignant pulmonary nodules
Objective To compare the value of low-dose spiral CT and conventional-dose CT for diagnosis of benign and malignant pulmonary nodules,so as to provide a reference for early screening of lung cancer.Methods A total of 288 pa-tients diagnosed with pulmonary nodules in Ningguo Municipal People's Hospital during the period from January 2019 to August 2023 were enrolled,and all patients underwent low-dose chest spiral CT and conventional-dose CT scans.The patho-logical biopsy of pulmonary nodules served as a gold standard.The sensitivity,specificity,and accuracy of low-dose spiral CT and conventional-dose CT for diagnosis of benign and malignant pulmonary nodules and the detection rates of vascular aggregation sign,pleural indentation sign,lobulation sign,and spiculation sign were compared.Results The 288 patients with pulmonary nodules included 186 men and 102 women,with a mean age of 61.12±8.34 years.Among these patients,218 had benign pulmonary nodules and 70 had malignant pulmonary nodules.There were no significant differences between patients with benign and malignant pulmonary nodules in terms of sex,mean age,and the size,location,and characteristics of pulmonary nodules(all P values>0.05).However,significant differences were observed in terms of changes in pulmon-ary nodule size,history of smoking,history of pulmonary infections,and family history of cancers(all P values<0.05).With pathological biopsy of pulmonary nodules as a gold standard,the sensitivity,specificity,and accuracy of conventional-dose CT and low-dose spiral CT for diagnosis of benign and malignant pulmonary nodules were 94.29%and 92.86%,93.57%and 92.20%,and 93.75%and 92.36%,respectively,with no significant differences(χ2=1.975,1.012,and 1.911,all P values>0.05).There was no significant difference in the area under the receiver operating characteristic curve between conventional-dose CT and low-dose spiral CT(0.937 vs.0.921;t=1.021,P>0.05).The detection rates of vascular aggregation sign,pleural indentation sign,lobulation sign,and spiculation sign were 20.49%and 19.79%,23.26%and 22.57%,37.50%and 35.76%,and 29.17%and 27.43%,respectively,for conventional-dose CT and low-dose spiral CT,with no significant differ-ences(χ2=0.171,0.212,1.012,and 1.110,all P values>0.05).Conclusion The diagnostic sensitivity,specificity,and ac-curacy of benign and malignant pulmonary nodules and the detection rate of pulmonary nodule signs are comparable between conventional-dose CT and low-dose spiral CT.However,low-dose spiral CT has lower radiation dose and higher safety,which deserves extensive applications in early screening for lung cancer.
Low-dose spiral CTPulmonary noduleDifferential diagnosisDiagnostic valueRadiation does
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