A Novel Method for the Generation of Realistic Lung Nodules Visualized Under X-Ray Imaging.

Objective: Image-guided diagnosis and treatment of lung lesions is an active area of research. With the growing number of solutions proposed, there is also a growing need to establish a standard for the evaluation of these solutions. Thus, realistic phantom and preclinical environments must be established. Realistic study environments must include implanted lung nodules that are morphologically similar to real lung lesions under X-ray imaging.

Methods: Various materials were injected into a phantom swine lung to evaluate the similarity to real lung lesions in size, location, density, and grayscale intensities in X-ray imaging. A combination of n-butyl cyanoacrylate (n-BCA) and ethiodized oil displayed radiopacity that was most similar to real lung lesions, and various injection techniques were evaluated to ensure easy implantation and to generate features mimicking malignant lesions.

Results: The techniques used generated implanted nodules with properties mimicking solid nodules with features including pleural extensions and spiculations, which are typically present in malignant lesions. Using only n-BCA, implanted nodules mimicking ground glass opacity were also generated. These results are condensed into a set of recommendations that prescribe the materials and techniques that should be used to reproduce these nodules.

Conclusions: Generated recommendations on the use of n-BCA and ethiodized oil can help establish a standard for the evaluation of new image-guided solutions and refinement of algorithms in phantom and animal studies with realistic nodules.