CT Scan

At present, computed tomography (CT) is the best radiological procedure for demonstrating calcium in a coin lesion.

  1. CT is much more sensitive to differences in density. CT can electronically determine the density of a coin lesion in units less than 1 cubic mm. Because of the greater sensitivity of CT in determining density, calcifications can be identified with CT before they can be identified by other radiographic methods.
  2. CT provides thin axial (cross section) views of the chest so that the coin lesion is demonstrated free of overlapping anatomical structures.

In many patients, the lesion is considered to be probably calcified. Fluoroscopy with spot films or tomography in these patients will usually demonstrate the calcification so that it can be definitely identified. These procedures are much less expensive than CT. If a lesion has no sign of calcification on radiographs, initial examination by CT is identified.

There is controversy regarding the utility of CT for coin lesions. I like to routinely obtain a CT of the chest for non-calcified coin lesions for the following reasons: