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SummaryAs part of a more general effort to probe the interrelated factors impacting the accuracy and precision of lung nodule size estimation, we have been conducting phantom CT studies with an anthropomorphic thoracic phantom containing a vasculature insert on which synthetic nodules were inserted or attached.The utilization of synthetic nodules with known truth regarding size and location allows for bias and variance analysis, enabled by the acquisition of repeat CT scans. Using a factorial approach to probe imaging parameters (acquisition and reconstruction) and nodule characteristics (size, density, shape, location), ten repeat scans have been collected for each protocol and nodule layout. The resulting database of CT scans is incrementally becoming available to the public via The Cancer Imaging Archive (TCIA) to facilitate the assessment of lung nodule size estimation methodologies and the development of image analysis software among other possible applications. ModalitiesCTNumber of Patients7Number of Studies76Number of Series4,433Number of Images1,468,751Image Size (GB)728.5Database Description The anthropomorphic thoracic phantom (Kyotokagaku Incorporated, Tokyo, Japan) employed in this study is shown in Figure 1, along with the vasculature insert on which synthetic nodules were attached before CT imaging. The phantom does not contain lung parenchyma so the space within the vascular structure is filled with air.Fig 1: Photograph of the exterior shell of the thoracic phantom (left) and the vasculature insert (right).The synthetic lung nodules used in our data CT scans were manufactured by either Kyotokagaku Incorporated (Japan) and Computerized Imaging Reference Systems (CIRS, Norfolk, VA). They consisted of objects varying in size (5, 8, 10, 12, 20, 40 mm), shape (spherical, elliptical, lobulated, spiculated), and density (-800, -630, -10, +100 HU). Figure 2 shows examples of the various sizes and shapes of synthetic nodules used in our CT data collection.Eight different layouts of nodules were specified by placing them in premarked positions within the phantom vasculature, where they were either attached to vessels or suspended in foam (non-attached configuration).
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Care was taken to maintain constant positioning of the nodules when a particular layout was scanned multiple times or with different protocols. For that purpose, vessels on which nodules were attached were color coded. Table 1 tabulates the nodule configuration for the nodule layouts that are currently available at in terms of nodule positioning, size, shape, and density.
Figures 3-6 show a schematic diagram of the currently available layouts. All tables and figures in this document will be updated as more data is posted.Figure 2: Photographs of the different types of synthetic nodules used in this study. Each column shows example nodules in three sizes, with lobulated, elliptical, spiculated, spherical, and irregular nodules shown from left to right. The three sizes shown here were manufactured to have the equivalent volumes of spherical nodules with diameters of 5, 10, and 20 mm (with the exception of the irregular shapes which have nominal diameters of about 5, 10, 12 mm). Additional nodules used in this study span the size range between 5-60mm. Nodule layoutVessel attachmentNodule placement and descriptionLeft lungRight lungNominal diameter (mm)Shape.HUNominal diameter (mm)ShapeHU1attached5,8,10SPH-8005,8,10SPH-6302attached5,8,10SPH1008,12,15irregular-300, 30,303attached5,8,10,20,40SPH1005,8,10,20,40SPH-6304attached10, 20, 10, 20,10, 20ELL, ELL, LOB, LOB, SPI, SPI-63010, 20, 10, 20,10, 20ELL ^, ELL, LOB, LOB, SPI, SPI100Table 1.
Summary of currently available nodule layouts.SPH- spherical, ELL- elliptical, LOB- lobulated, SPI- spiculated. ^Note: The 10mm, 100HU elliptical nodule in the right lung has a large hole in it.
A replacement was scanned as part of Nodule 6 which will be released by the end of 2014.The phantom was scanned using a Philips 16-row scanner (Mx8000 IDT, Philips Healthcare, Andover, MA) and a Siemens 64-row scanner (Somatom Definition 64, Siemens Medical Solutions USA, Inc., Malvern, PA). Scans were acquired with varying combinations of effective dose, pitch, and slice collimation, and were reconstructed with varying combinations of slice thicknesses and reconstruction kernels. Ten exposures were acquired for each imaging protocol. The phantom position was not changed during the 10 repeat exposures; however it was repositioned between different imaging protocols or different nodule layouts. Table 2 summarizes the imaging protocols for the nodule layout.NOTE: Each study in the database contains 10 repeat scans for that particular acquisition protocol, multiplied by the number of reconstructions. NoduleLayout, ScannerEff.dose(mAs)Slice collimation (mm)Slice overlapPitchRecon.
Slice thickness (mm)Recon. Kernels# sets1,S120,50,100,20016x0.75,(16x1.5)50%0.9,1.20.75,1.5,3 (2,3,5)C4802, S120,100,20016x0.75,(16x1.5)50%0.9,1.20.75,1.5,3 (2,3,5)C, B7203, S225, 100, 20064x0.60%, 50%0.9, 1.20.75, 1.5, 3.0B40f, B60f7204, S125, 100, 20016x0.75,(16x1.5)50%0.9,1.20.75,1.5,3 (2,3,5)C, B720TOTAL2640Table 2. Summary of reconstructed CT datasets: a description of the individual nodule layouts are provided in Table 3.S1: 16-row Philips Mx8000 IDT (Philips Healthcare, Andover, MA), S2: 64-row Siemens Somatom (Siemens, Erlangen, Germany).For example: there are 16 studies for Nodule Layout #1 (4 exposures x 2 slice collimations x 2 pitch settings). Each study contains 30 series (10 repeat scans x 3 reconstructed slice thickness x 1 reconstruction kernel).A key component of the CT lung phantom project is the ability to compare the estimated nodule size with the known true size or reference gold standard. As part of our project, volume was used as a surrogate measure of size. The true volume estimate of each synthetic nodule was derived from weight and density measures.
Both the CIRS-and Kyotokagaku nodules were accompanied by density measures. Nodule weights were measured in our lab using a precision scale of 0.1 mg tolerance (Adventurer Pro AV 2646, Ohaus Corp, Pine Brook, NJ).
Three repeat weight measurements were made and these weights were averaged to produce a final estimated weight for each nodule. Our estimates of the true volume of the synthetic nodules in each layout are summarized in Table 3 along with approximated xyz location (based on 0.8mm slice thickness) of nodule center in the CT scans.This phantom and the associated synthetic nodules designed in our lab have been used in a number of studies examining the accuracy and precision of volumetric measurements using CT. NoduleLayoutRight lung nodulesLeft lung nodulesNom. Diam.(mm)ShapeHUx y zVol(µl)Nom.
Diam.(mm)ShapeHUx y zVol (µl)15SPH-630177 342 192715SPH-800340 325 168628SPH-630179 2SPH-800343 20SPH-630170 30SPH-800394 28irr-300184 2SPH100335 3irr30170 3SPH100351 25irr30189 30SPH100395 25SPH-630192 350 562715SPH100338 328 580648SPH-630185 2SPH100355 20SPH-630170 30SPH100394 20SPH-630157 220SPH100384 240SPH-630168 2440SPH100373 21410ELL-630176 30ELL100341 30ELL-630169 30ELL100401 210LOB-630159 30LOB100395 20LOB-630136 220LOB100349 310SPI-630167 30SPI100357 20SPI-630133 220SPI100386 2Table 3. Approximate center location and estimated true volume of synthetic lung nodules in each nodule layout based on 0.75mm slice thickness, 0.4mm slice increment CT scans. (SPH=spherical, ELL=elliptical, LOB= lobulated, SPI= spiculated, irr=irregular)Contact info:Marios GavrielidesDivision of Imaging Diagnostics and Software ReliabilityOffice of Science and Engineering LaboratoriesCenter for Devices and Radiological HealthU.S. Food and Drug Administration10903 New Hampshire Ave.Bldg.
62, Rm.3139Silver Spring, MD 20993, USATel. (301) 796-2545Appendix 1Figure 3. Schematic diagram of Nodule Layout#1 in terms of nodule placement.
Vessel branches within the anthropomorphic phantom were color coded for the purpose of mapping nodules to specific positions within the phantom’s vasculature structure in a reproducible manner.Figure 4. Schematic diagram of Nodule Layout#2 in terms of nodule placement.
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