Computed Tomographic Scanning of the Thorax in the Staging of Bronchogenic Carcinoma

Underwood, George H.; Hooper, Robert G.; Axelbaum, Stewart P.; Goodwin, Donald W.; Kuhns, Lawrence R.

doi:10.1097/00004728-197910000-00043

Cited by 5 publications

(5 citation statements)

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“…In another study of 18 patients, CT was 67 percent accurate (6 percent false-positives, 28 percent false-negatives) in predicting middle mediastinal metastasis from lung cancer. 11 As above, the high false-negative rate was caused by cancerous deposits in lymph nodes that were not enlarged. Despite this deficiency, CT provided important additional information about the mediastinum in 17 percent of cases.…”

Section: Evaluation Of Lung Cancermentioning

confidence: 90%

Examination of the Chest with Computed Tomography

Godwin

1983

Semin Respir Crit Care Med

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Section: Evaluation Of Lung Cancermentioning

confidence: 90%

Examination of the Chest with Computed Tomography

Godwin

1983

Semin Respir Crit Care Med

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“…In general, the results confirm a high degree of sensitivity in the detection of enlarged mediastinal nodes. In the small series by Underwood et al (1979), CT failed to detect abnormal nodes in five of nine patients Galen (1975). Galen (1975). shown to have malignant nodal involvement by mediastinoscopy; the authors attributed this low sensitivity (44%) to microscopic intranodal metastasis in the absence of marked lymph node distortion or enlargement.…”

Section: Conventional and Computed Mediastinal Tomographymentioning

confidence: 94%

Pre-operative mediastinal evaluation in primary bronchial carcinoma—a review of staging investigations

Elliott

1984

Postgraduate Medical Journal

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Summary A review of staging investigations in the preoperative evaluation of mediastinal involvement in primary bronchial carcinoma is presented. The following conclusions are offered as guidelines for the use of mediastinal staging procedures in clinical practice: Surgical staging methods have the over-riding advantage of superior specificity over indirect imaging techniques. Where 67Ga-imaging or CT scanning are not available, routine pre-operative mediastinoscopy or, when appropriate, mediastinotomy will identify most patients with non-resectable disease but this approach entails a high proportion of true negative examinations. Radioisotope ventilation and perfusion lung imaging has no place in the pre-operative staging of lung cancer. Where the techniques are available, 67Ga-imaging and CT scanning have a use in selecting patients for mediastinal exploration. A negative mediastinal 67Ga scan or a negative CT examination suggest that mediastinal exploration will be unrewarding in the vast majority of cases and may be omitted prior to thoracotomy. A positive mediastinal 67Ga scan or the demonstration of abnormal mediastinal nodes by CT is an indication for mediastinal exploration which, if negative should be followed by thoracotomy.

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“…Mintzer et a1.2' and Underwood et a1. 16 concluded that, although CT could predict mediastinal node involvement in a large fraction of cases, false-negatives ranged from 15% to 3696, with 2% false-positives. They also concluded that conventional tomograms were more sensitive for determining mediastinal involvement.…”

Section: Fig 5 False-negative Mediastinal Diagnosis (Reader Error)mentioning

confidence: 99%

Accuracy of chest computerized tomography in detecting malignant hilar and mediastinal involvement by squamous cell carcinoma of the lung

Frederick

Bernardino

Baron

et al. 1984

Cancer

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The accuracy of chest computerized tomography (CT) in detecting malignant hilar and mediastinal involvement by squamous cell carcinoma of the lung is examined. The preoperative chest CT scans of 74 patients with pathologically proven squamous cell lung carcinoma were prospectively and retrospectively reviewed. Criteria for the diagnosis of malignant hilar involvement were nonvascular mass enlarging the hilum; local alteration of hilar contour; adenopathy greater than 1 cm; thickened posterior wall of the bronchus intermedius and distal upper lobe bronchi; and bronchial displacement, compression, and obstruction. Criteria for the diagnosis of malignant mediastinal involvement were confluence of tumor with the mediastinum, altered contour of the azygoesophageal recess, thickened posterior wall of the proximal main stem bronchi, and mediastinal adenopathy greater than 1 cm. Calcified hilar and mediastinal nodes were considered benign. Our results, corrected for reader error, were 92% sensitive, 92% specific, and 96% accurate in the hilum and 95% sensitive, 77% specific, and 82% accurate in the mediastinum. These data support a significant role for chest CT in the preoperative staging of non small cell lung carcinoma.

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Computed Tomographic Scanning of the Thorax in the Staging of Bronchogenic Carcinoma

Cited by 5 publications

References 0 publications

Examination of the Chest with Computed Tomography

Examination of the Chest with Computed Tomography

Pre-operative mediastinal evaluation in primary bronchial carcinoma—a review of staging investigations

Accuracy of chest computerized tomography in detecting malignant hilar and mediastinal involvement by squamous cell carcinoma of the lung

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