Factors influencing the outcome of volumetry tools for pulmonary nodule analysis: a systematic review and attempted meta-analysis

Insights into Imaging

Critical Review

Edson Marchiori¹  Colin Monaghan²  Klaus Irion³  Sofia Ravara⁴  Erique Guedes Pinto⁴  Luís Taborda-Barata⁴  Diana Penha⁵  Bruno Hochhegger⁶ 

[1] Faculdade de Medicina, Universidade Federal Do Rio de Janeiro, Bloco K - Av. Carlos Chagas Filho, 373 - 2º Andar, Sala 49 - Cidade Universitária da Universidade Federal Do Rio de Janeiro, 21044-020, Rio de Janeiro - RJ, Brasil;Faculdade de Medicina, Universidade Federal Fluminense, Av. Marquês Do Paraná, 303 - Centro, 24220-000, Niterói - RJ, Brasil;Liverpool Heart and Chest Hospital NHS Foundation Trust, Thomas Dr, L14 3PE, Liverpool, UK;Manchester University NHS Foundation Trust, Manchester Royal Infirmary, Oxford Rd, M13 9WL, Manchester, UK;R. Marquês de Ávila E Bolama, Universidade da Beira Interior Faculdade de Ciências da Saúde, 6201-001, Covilhã, Portugal;R. Marquês de Ávila E Bolama, Universidade da Beira Interior Faculdade de Ciências da Saúde, 6201-001, Covilhã, Portugal;Liverpool Heart and Chest Hospital NHS Foundation Trust, Thomas Dr, L14 3PE, Liverpool, UK;University of Florida, 32611, Gainesville, FL, USA;

关键词: Systematic review;    Screening;    Cancer;    Lung cancer;    Computed tomography;    Spiral;   

DOI  :  10.1186/s13244-023-01480-z

 received in 2023-04-18, accepted in 2023-07-08,  发布年份 2023

来源: Springer

【 摘 要 】

AbstractHealth systems worldwide are implementing lung cancer screening programmes to identify early-stage lung cancer and maximise patient survival. Volumetry is recommended for follow-up of pulmonary nodules and outperforms other measurement methods. However, volumetry is known to be influenced by multiple factors. The objectives of this systematic review (PROSPERO CRD42022370233) are to summarise the current knowledge regarding factors that influence volumetry tools used in the analysis of pulmonary nodules, assess for significant clinical impact, identify gaps in current knowledge and suggest future research. Five databases (Medline, Scopus, Journals@Ovid, Embase and Emcare) were searched on the 21st of September, 2022, and 137 original research studies were included, explicitly testing the potential impact of influencing factors on the outcome of volumetry tools. The summary of these studies is tabulated, and a narrative review is provided. A subset of studies (n = 16) reporting clinical significance were selected, and their results were combined, if appropriate, using meta-analysis. Factors with clinical significance include the segmentation algorithm, quality of the segmentation, slice thickness, the level of inspiration for solid nodules, and the reconstruction algorithm and kernel in subsolid nodules. Although there is a large body of evidence in this field, it is unclear how to apply the results from these studies in clinical practice as most studies do not test for clinical relevance. The meta-analysis did not improve our understanding due to the small number and heterogeneity of studies testing for clinical significance.Critical relevance statementMany studies have investigated the influencing factors of pulmonary nodule volumetry, but only 11% of these questioned their clinical relevance in their management. The heterogeneity among these studies presents a challenge in consolidating results and clinical application of the evidence.Key points• Factors influencing the volumetry of pulmonary nodules have been extensively investigated.• Just 11% of studies test clinical significance (wrongly diagnosing growth).• Nodule size interacts with most other influencing factors (especially for smaller nodules).• Heterogeneity among studies makes comparison and consolidation of results challenging.• Future research should focus on clinical applicability, screening, and updated technology.Graphical abstract

【 授权许可】

CC BY   
© European Society of Radiology (ESR) 2023

【 图 表 】

Fig. 3

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