The Value of Radiographic and Computed Tomography in the Staging of Lung Carcinoma

Joseph W. Lewis, Beatrice L. Madrazo, Steven C. Gross, William R. Eyler, Donald J. Magilligan, Paul A. Kvale, Robert A. Rosen

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

A prospective double-blind study was undertaken to compare computed tomography (CT) and conventional radiographic tomography (RT) in the staging of lung carcinoma. Seventy-five patients had CT and RT of the mediastinum and hilum prior to operation. The presence or absence of metastasis to lymph nodes documented at the time of operation was the standard applied to the studies. CT correctly predicted the presence or absence of mediastinal lymphadenopathy in most cases (sensitivity 91%, specificity 94%), while RT was less helpful (sensitivity 61%, specificity 86%). Metastatic mediastinal lymph nodes in those patients with false negative CT and RT studies averaged only 0.8 cm in diameter, probably accounting for the negative radiographic findings. Both CT and RT had poor predictive values in detecting hilar lymphadenopathy (sensitivity 73% and 47%, specificity 87% and 72%, respectively). The predictive value of CT in the evaluation of mediastinal lymphadenopathy equaled that of mediastinoscopy or mediastinotomy. When CT of the mediastinum demonstrates no lymphadenopathy, invasive staging can be deferred for definitive thoracotomy. Since false positive values were seen with both CT and RT scans of the mediastinum (4% and 8%, respectively), invasive staging will still be necessary in those patients with positive studies.

Original languageEnglish (US)
Pages (from-to)553-558
Number of pages6
JournalAnnals of Thoracic Surgery
Volume34
Issue number5
DOIs
StatePublished - Jan 1 1982
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Lewis, J. W., Madrazo, B. L., Gross, S. C., Eyler, W. R., Magilligan, D. J., Kvale, P. A., & Rosen, R. A. (1982). The Value of Radiographic and Computed Tomography in the Staging of Lung Carcinoma. Annals of Thoracic Surgery, 34(5), 553-558. https://doi.org/10.1016/S0003-4975(10)63002-0