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Journal of Computer Assisted Tomography:
November/December 2007 - Volume 31 - Issue 6 - pp 943-949
doi: 10.1097/RCT.0b013e3180415e20
Thoracic Imaging: Original Article

Pulmonary Cavitary Nodules on Computed Tomography: Differentiation of Malignancy and Benignancy

Honda, Osamu MD, PhD; Tsubamoto, Mitsuko MD, PhD; Inoue, Atsuo MD, PhD; Johkoh, Takeshi MD, PhD; Tomiyama, Noriyuki MD, PhD; Hamada, Seiki MD, PhD; Mihara, Naoki MD, PhD; Sumikawa, Hiromitsu MD; Natsag, Javzandulam MD; Nakamura, Hironobu MD, PhD

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Abstract

Objective: To establish computed tomographic findings that enable accurate differentiation between malignant and benign cavitary lung nodules.

Methods: Computed tomographic scans from 39 patients with malignant cavitary nodules and from 39 patients with benign cavitary nodules were independently assessed by 2 observers. They recorded the computed tomographic findings of both types of cavitary nodules and surrounding pulmonary parenchyma. The computed tomographic findings were then compared using χ2 test.

Results: The notch was found in 29% of benign cavitary nodule cases and in 54% of malignant cavitary nodule cases (P < 0.01). An irregular internal wall was found in 26% of benign nodules and in 49% of malignant nodule cases (P < 0.01). A linear margin (P < 0.01), satellite nodule presence (P < 0.01), bronchial wall thickening (P < 0.05), consolidation (P < 0.05), and ground-glass attenuation (P < 0.01) were significantly more frequent in benign cavitary nodules than in malignant ones.

Conclusions: Although the computed tomographic findings of benign and malignant cavitary nodules overlap, some computed tomographic findings are useful for differentiating cavitary nodules.

© 2007 Lippincott Williams & Wilkins, Inc.

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