Optimal dose levels in screening chest CT for unimpaired detection and volumetry of lung nodules, with and without computer assisted detection at minimal patient radiation

OBJECTIVES The aim of this phantom study was to minimize the radiation dose by finding the best combination of low tube current and low voltage that would result in accurate volume measurements when compared to standard CT imaging without significantly decreasing the sensitivity of detecting lung nodules both with and without the assistance of CAD. METHODS An anthropomorphic chest phantom containing artificial solid and ground glass nodules (GGNs, 5-12 mm) was examined with a 64-row multi-detector CT scanner with three tube currents of 100, 50 and 25 mAs in combination with three tube voltages of 120, 100 and 80 kVp. This resulted in eight different protocols that were then compared to standard CT sensitivity (100 mAs/120 kVp). For each protocol, at least 127 different nodules were scanned in 21-25 phantoms. The nodules were analyzed in two separate sessions by three independent, blinded radiologists and computer-aided detection (CAD) software. RESULTS The mean sensitivity of the radiologists for identifying solid lung nodules on a standard CT was 89.7% ± 4.9%. The sensitivity was not significantly impaired when the tube and current voltage were lowered at the same time, except at the lowest exposure level of 25 mAs/80 kVp [80.6% ± 4.3% (p = 0.031)]. Compared to the standard CT, the sensitivity for detecting GGNs was significantly lower at all dose levels when the voltage was 80 kVp; this result was independent of the tube current. The CAD significantly increased the radiologists' sensitivity for detecting solid nodules at all dose levels (5-11%). No significant volume measurement errors (VMEs) were documented for the radiologists or the CAD software at any dose level. CONCLUSIONS Our results suggest a CT protocol with 25 mAs and 100 kVp is optimal for detecting solid and ground glass nodules in lung cancer screening. The use of CAD software is highly recommended at all dose levels.

Volumetric analysis of lung nodules in computed tomography (CT): comparison of two different segmentation algorithm softwares and two different reconstruction filters on automated volume calculation.

BACKGROUND A precise detection of volume change allows for better estimating the biological behavior of the lung nodules. Postprocessing tools with automated detection, segmentation, and volumetric analysis of lung nodules may expedite radiological processes and give additional confidence to the radiologists. PURPOSE To compare two different postprocessing software algorithms (LMS Lung, Median Technologies; LungCARE®, Siemens) in CT volumetric measurement and to analyze the effect of soft (B30) and hard reconstruction filter (B70) on automated volume measurement. MATERIAL AND METHODS Between January 2010 and April 2010, 45 patients with a total of 113 pulmonary nodules were included. The CT exam was performed on a 64-row multidetector CT scanner (Somatom Sensation, Siemens, Erlangen, Germany) with the following parameters: collimation, 24x1.2 mm; pitch, 1.15; voltage, 120 kVp; reference tube current-time, 100 mAs. Automated volumetric measurement of each lung nodule was performed with the two different postprocessing algorithms based on two reconstruction filters (B30 and B70). The average relative volume measurement difference (VME%) and the limits of agreement between two methods were used for comparison. RESULTS At soft reconstruction filters the LMS system produced mean nodule volumes that were 34.1% (P < 0.0001) larger than those by LungCARE® system. The VME% was 42.2% with a limit of agreement between -53.9% and 138.4%.The volume measurement with soft filters (B30) was significantly larger than with hard filters (B70); 11.2% for LMS and 1.6% for LungCARE®, respectively (both with P < 0.05). LMS measured greater volumes with both filters, 13.6% for soft and 3.8% for hard filters, respectively (P < 0.01 and P > 0.05). CONCLUSION There is a substantial inter-software (LMS/LungCARE®) as well as intra-software variability (B30/B70) in lung nodule volume measurement; therefore, it is mandatory to use the same equipment with the same reconstruction filter for the follow-up of lung nodule volume.

Die beiden Systeme der hebräischen Vocal- und Accentzeichen

Michel Friedländer

(Table 11-I, page 338) Metal contents (%) of a representative sampling of manganese nodules from the North Pacific high-grade region

Two types of deep-sea dredges are currently under development for the mining of the manganese nodules, a deep-sea hydraulic dredge and a mechanical cable-bucket system. Both systems offer some advantages with the hydraulic system appearing to be advantageous in themining of a specific deposit for which it is designed while the cable-bucket system appears to be somewhat more flexible in working in a variety of deposits, topographic environments, and water depths. Environmental studies conducted in conjunction with deep-sea tests of the two types of mining systems currently indicate that substantially no environmental damage will be done in the mining of the deep-sea nodules. Because of the nature of the deposits and the way in which they can be mined, the manganese nodules appear to be a relatively pollution free and energy-saving source of a number of industrially important metals.

Permian manganese nodules near Dillon, Montana

Concentrically ringed manganese nodules, similar in form to many found on modern ocean and sea floors, occur in a very fine grained argillaceous sandstone bed of the Permian Park City Formation near Dillon, Montana. They are enriched in many rare elements and contain us much as 2.5 percent zinc, l.3 percent nickel, and 0.22 percent cobalt. The manganese minerals are chalcophanite and todorokite. The nodules probably formed in a shallow marine oxidizing environment on the western side of the Permian sedimentary basin. The occurrence of an appreciable amount of fluorite in the bed suggests that the water was saline.

Annotated record and chemical composition of iron-manganese nodules from the Baltic Sea

Iron-manganese concretions, closely related to lacustrine ores and deep sea manganese nodules, are presently forming in different parts of Gulfs of Bothnia and Finland. They can be divided according to physical form into three distinct groups: (1) round pea-shaped concretions, (2) ring-shaped concrections, and (3) flat sheets and crusts of concretionary material. A definite correlation was found to exist between the form i.e. type of concretions and their chemical composition (Mn/Fe ratio). Trace element concentrations were generally rather high, although not as high as in deep sea manganese nodules. X-ray and DTA was used to study the mineralogy and crystal structure of the concretions. Surface concentrations and geographical distribution of the concretions were estimated on the basis of samples, diving observations and echo-grams.

Geochemistry of manganese nodules from a British Columbia fjord

Concretions of iron and manganese oxides and hydrous oxidesóobjects commonly called manganese nodulesóare widely distributed not only on the deep-sea floor but also in shallow marine environments1. Such concretions were not known to occur north of Cape Mendocino in the shallow water zones bordering the North-East Pacific Ocean until the summer of 1966 when they were recovered by one of us (J. W. M.) in dredge samples from Jervis Inlet, a fjord approximately 50 miles north-west of Vancouver, British Columbia.

Description and chemical composition of the fossil manganese nodules of the Cambrian manganese deposits of Conception and Trinity bays, Newfoundland

This paper is based upon data collected during the summers of 1912 and 1913. Mr. A. O. Hayes and Prof. van Ingen of Princeton University, while making a study of the general geology, stratigraphy, and palaeontology of the shores of Conception Bay, Newfoundland, came upon the manganiferous rocks of the Lower Cambrian exposed at Manuels, Topsail, Brigus, and other places. The following summer, of 1913, the writer as a member of the Princeton Newfoundland Expedition undertook a more detailed study of these deposits. In this paper therefore there has been an attempt to present as comprehensive a study of the manganese of southeastern Newfoundland. It is primarily chemical in its nature and the analyses herewith presented are from samples taken from the principal manganese-bearing beds.

Geochemical composition of a representative collection of manganese nodules and slabs collected in the Western Pacific

Chemical analyses were performed on seveteen manganese nodules collected from the Pacific Ocean floor. The results were discussed compared with the previous data on the manganese nodules. Minerals were found to be todorokite, delta-MnO2 and other silicates, montmorillonite, illite, phillipsite and alpha-SiO2. Average composition shows that copper is concentrated on the deep sea nodules more than the shallow ones, and that the todorokite rich nodules contain more copper and nickel than the delta-MnO2 rich ones.

Annotated record and chemical composition of manganese nodules from station VITYAZ 4575, Indian Ocean

Analyses are given for the core and outer colliform shell of a manganese nodule collected at a depth of 5000 m in the Indian Ocean, and for the red clay that encloses the nodules. Trace elements determined include rare earths, Nb, Ta, Th, and V. The cores of the nodules were once composed of basaltic rock, but now are phillipsite and nontronite. The outer shell is composed of manganite, with admixed quartz, phillipsite, and some geothite. The correlations established between the redox potentials and the concentration coefficients for 12 elements indicate that Eh plays a greater role in the formation of the manganiferous shells than coprecipitation properties.

On the composition of oceanic and littoral manganese nodules (published online 2015)

The following analyses were made some years ago, principally with the object of ascertaining the state of oxidation of the manganese in the nodules. The nodules examined came from three different localities, two of them oceanic and the third littoral. Samples marked I., II., and III. are from nodules brought up in the trawl on board the "Challenger," on 13th March 1874, in lat. 42° 42' S., long. 134° 10' E. The depth of the water was 2600 fathoms, and the temperature of the bottom water 0·2° C. The density of the bottom water was 1·02570 at 15·56° C. Being from a high southern latitude, and therefore near the source of surface aeration, the water is highly charged with atmospheric gases, especially oxygen. It contained, per litre, 18·4 c.c. of mixed nitrogen and oxygen, of which 31·81 per cent, was oxygen, and 27·33 c.c, or 53·7 milligrammes, loosely-bound carbonic acid. The position of the station is about 400 miles south-west of the nearest part of the Australian coast, and about 500 miles west of Tasmania. It was the deepest water observed in the Antarctic voyage between the Cape of Good Hope and Melbourne. The haul was a very abundant one, and a few notes which I made at the time may be interesting: -"The water was found unexpectedly deep, the bottom being red clay, with some Foraminifera.

Chemical composition of Lake George (New York) iron-manganese nodules and underlying sediment

Lake George, New York, is the site of a new discovery of iron-manganese nodules. These nodules occur at a water depth between 21 and 36 m along a stretch of lake extending for about 5 mi north and south of the Narrows, a constricted island-dotted area which separates the north and south Lake George basins. Nodules occur on or within the uppermost 5 cm of a varved glacial clay. Some areas are solidly floored with a carpet of nodules in areas where active currents keep the nodules exposed. The nodules form around nuclei which consist of clay and less commonly of spore capsules, detrital particles, or bark. By their shape we recognize three types of nodules: spherical, discoidal, and lumps. On X-ray examination all nodules show small goethite peaks; in one nodule the manganese mineral birnessite was identified. Manganese and part of the iron appears to be in X-ray amorphous ferromanganese compounds. The Lake George nodules are enriched in iron with respect to marine nodules but are lower in manganese. They have a higher trace element concentration than nodules from other known freshwater lake occurrences, but a lower concentration than marine nodules.

Description and chemical composition of manganese nodules collected in the Pacific Ocean

Chemical and X-ray analyses were performed on the fifteen manganese nodules collected from the Pacific Ocean floor. The results were discussed compared with the previous data on the manganese nodules. Minerals were found to be todorokite, delta-MnO2 and other silicates, montmorillonite, illite, phillipsite and alpha-Si02. Average composition shows that copper is concentrated on the deep sea nodules more than the shallow ones, and that the todorokite rich nodules contain more copper and nickel than the delta-MnO2 rich ones. The analyses of fresh water iron-manganese precipitates by bacterial activity suggest that biological process is one of the important factors on the genesis of the sedimentary iron-manganese deposits, in¬cluding the manganese nodule.

(Table 1) Contents of tungsten and other metals in Fe-Mn nodules from the Pacific Ocean

Tungsten contents in iron-manganese nodules and crusts from different parts of the World Ocean, as well as its relationships with a number of chemical elements are under consideration. A trend to correlation of tungsten with Fe, Ti, W, Pb, and Co is noticed. Comparison of tungsten contents in the nodules and host sediments indicates its low geochemical mobility.