Solitary and Multiple Pulmonary Nodules – Analysis of MorphologicalProperties and Demonstration of Their Etiology, Observation Principlesof Small Nodules, Their Detection by Semiautomatic Analysisof CT Scan – the Authors’ Experience and Review of Li terature

Overview

The authors summarize the present state of detection and demonstration of the etiologyof lung nodules. Bronchogenic carcinoma is the main cause of death for malignantdiseases in the European Union countries and the U.S.A. and also all over the world.5 year survival is less than 15%. At the present time there is a large difference betweenthe survival in stage I.A (5 year survival is about 60%) and stage IV (5 year survival lessthan 1%). Screening low-dose CT studies are performed in Europe and the U.S.A. (a studywith 50,000 persons started in 2004). Final results of the prospective, randomized,controlled study related to the outcome of decreasing mortality will be available in2010 at the earliest. The National Oncologic Register in the Czech Republic has shownthat annually 4,589 men and 1,397 women fell ill. The mortality is getting close to incidence– 4,219 men and 1,339 women annually – and bronchogenic carcinoma participatesin mortality for tumours with 26%.The authors describe the rule for observation small lung nodules in the group of lowand high risk patients in relation to their size by means of computed tomography (CT).The last recommendations of the Fleischner society in 2005 classify the nodules intothree groups and recommends suitable intervals for repeated CT.In the introduction of screening for pulmonary carcinoma it is also possible to use theautomatic or semiautomatic analysis of images – diagnostics with the help of computer– computer assisted diagnosis (CAD). In addition to giving more precision to thedemonstration of small nodules, these systems make it possible to calculate more preciselytheir volume and changes of volumes during time. The authors present theirown results in the development of software in collaboration with Czech Institute ofTechnology.

Key words:
solitary pulmonary nodule – low-dose CT – semiautomatic image analysis