Lung nodules: Dual-kilovolt peak analysis with CT - Multicenter study

Stephen J. Swensen, Keiji Yamashita, Cynthia H. McCollough, Robert W. Viggiano, David E. Midthun, Edward F. Patz, John R. Muhm, Amy L. Weaver

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


PURPOSE: To test the following hypothesis: The greater the increase in the mean computed tomographic (CT) number of a radiologically indeterminate lung nodule from the CT number on a 140-kVp CT image to that on an 80-kVp CT image, the more likely the nodule is benign (ie, contains calcium). MATERIALS AND METHODS: Two hundred forty indeterminate lung nodules were prospectively studied at four institutions: Mayo Clinic Scottsdale, Ariz (n = 160); Mayo Clinic Rochester, Minn (n = 50); Shiga Health Insurance Hospital, Otsu, Japan (n = 25); and Duke University Medical Center, Durham, NC (n = 5). Of the 240 nodules, 157 met the entrance criteria for this study and had a diagnosis. All nodules included were solid, 5-40-mm diameter, relatively spherical, homogeneous, and without visible evidence of calcification or fat. Each nodule was evaluated by using 3-mm-collimation, nonenhanced CT scans with both 140- and 80-kVp x-ray beams. RESULTS: There were 86 (55%) benign and 71 (45%) malignant nodules. The median increase in the nodule mean CT number from the CT number on 140-kVp images to that on 80-kVp images was 2 HU for benign nodules and 3 HU for malignant nodules. This difference was not statistically significant. The area under the receiver operating characteristic curve was 0.505. CONCLUSION: Dual-kilovolt peak analysis with current CT technology does not appear to be helpful in the identification of benign lung nodules.

Original languageEnglish (US)
Pages (from-to)81-85
Number of pages5
Issue number1
StatePublished - 2000


  • Lung neoplasms, CT
  • Lung neoplasms, diagnosis
  • Lung, CT
  • Lung, nodule

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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