Non-solid lung nodules on low-dose computed tomography: comparison of detection rate between 3 visualization techniques

To compare various visualization techniques for the detection of non-solid nodules in low-dose lung cancer screening computed tomography (CT) scans. An enriched sample of 216 male lung cancer screening subjects aged 60.4 ± 6.0 years was used. Two blinded independent readers searched for non-solid nodules on 5-mm multiplanar reconstructions, 1-mm slices and 7-mm maximum intensity projections (trial protocol). The reference standard was a consensus diagnosis of all non-solid nodules reported at least once. Twenty-three individuals (10.6%) had in total 34 non-solid nodules. Interobserver agreement was good (Cohen kappa 0.89-0.95). For both observers, we found no differences between the 3 viewing techniques (P > 0.13). In low-dose lung cancer screening CT scans, we were unable to find a viewing technique superior to that used in the trial by experienced observers who focused on non-solid nodule detection.