MSCT-DENSITOMETRIC CRITERIA FOR MALIGNANCY OF PULMONARY NODULES IN LUNG MASSES
DOI:
https://doi.org/10.15407/oncology.2026.01.047Keywords:
multispiral computed tomography, pulmonary nodule, contrast-enhanced, ROC- analysis, X-ray densitometry, malignancyAbstract
Summary. Aim: to determine the optimal MSCT-densitometric threshold for identifying malignancy in pulmonary nodules based on contrast enhancement analysis and to evaluate its diagnostic performance. Materials and Methods: we analyzed 148 pathologically verified cases of lung masses (95 malignant and 53 benign). The increase in X-ray density (ΔHU) was measured during the arterial and venous phases of contrast-enhanced chest multispiral computed tomography (MSCT). Statistical analysis was performed using the Mann-Whitney U test and Receiver Operating Characteristic (ROC) analysis. Results: a statistically significant difference in contrast media accumulation was established between the groups (p < 0,001). The area under the ROC curve was AUC = 0.89 (95% CI: 0.81–0.96); z = 9.8. The optimal cut-off threshold was determined at ΔHU > 22,5, providing a sensitivity of 88.3% and a specificity of 86,8%. Conclusions: quantitative MSCT densitometry is a highly informative method for the differentiation of lung masses. Utilizing the 22.5 HU threshold allows for an objective diagnostic process and minimizes the number of unjustified invasive procedures.
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