ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Joseph W. Lewis, Jr
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lewis, J. W.
Right arrow Articles by Magilligan, D. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lewis, J. W., Jr
Right arrow Articles by Magilligan, D. J., Jr

Ann Thorac Surg 1990;49:591-596
© 1990 The Society of Thoracic Surgeons

Articles

Can computed tomography of the chest stage lung cancer?—Yes and no

Joseph W. Lewis, Jr, MD*, Jay L. Pearlberg, MD, Gordon H. Beute, MD, Michael Alpern, MD, Paul A. Kvale, MD, Barry H. Gross, MD, Donald J. Magilligan, Jr, MD

Division of Thoracic and Cardiac Surgery, Departments of Radiology and Pulmonary Medicine, Henry Ford Hospital, Detroit, Michigan USA

* Address reprint requests to Dr Lewis, Thoracic and Cardiac Surgery, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202.

To determine the accuracy of computed tomography (CT) of the chest in the staging of lung cancer, we studied 418 patients with primary pulmonary carcinoma between 1979 and 1986. Each had a preoperative scan performed before detailed operative staging. Each CT scan was analyzed for components of the current TNM staging system. Computed tomography sensitivity and specificity for mediastinal lymph node metastasis were 84.4% and 84.1%, with corresponding positive and negative predictive accuracies of 68.7% and 92.9%, respectively. When TNM stages were derived from CT scans, only 190 of 418 (45.4%) completely agreed with operative staging. An additional 53 of 418 (12.7%) predicted the correct stage, although components of the TNM system were incorrect. In 94 of 418 scans (22.5%) CT overestimated the stage, whereas in 81 (19.4%) CT downgraded the stage. Computed tomography suggested metastatic lesions in liver, lung, adrenal gland, bone, or abdominal lymph nodes in 40 of 373 scans (10.7%); only five of 40 (12.5%) had documented metastasis. In summary, CT of the chest cannot accurately stage primary lung carcinoma according to the TNM classification. Because the negative predictive accuracy for mediastinal lymph node metastasis remains high (92.9%), invasive staging can be deferred for definitive thoracotomy when no lymphadenopathy is evident on CT. The high negative predictive accuracy for scans of the chest and upper abdomen makes CT a useful tool for exclusion of metastatic disease.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
T. G. Lesser
Endothoracic Sonography Improves the Estimation of Operability in Locally Advanced Lung Cancer
Ann. Thorac. Surg., July 1, 2010; 90(1): 217 - 221.
[Abstract] [Full Text] [PDF]

Home page
 Imaging vol 30Home page
J. A. Verschakelen, W. De Wever, J. Bogaert, and S. Stroobants
Imaging: staging of lung cancer
Imaging, June 28, 2010; 214 - 244.
[Abstract] [Fulltext] [PDF]

Home page
 ChestHome page
F. Detterbeck, J. Puchalski, A. Rubinowitz, and D. Cheng
Classification of the Thoroughness of Mediastinal Staging of Lung Cancer
Chest, February 1, 2010; 137(2): 436 - 442.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. Singh, B. Camazine, Y. Jadhav, R. Gupta, P. Mukhopadhyay, A. Khan, R. Reddy, Q. Zheng, D. D. Smith, R. Khode, et al.
Endoscopic Ultrasound As a First Test for Diagnosis and Staging of Lung Cancer: A Prospective Study
Am. J. Respir. Crit. Care Med., February 15, 2007; 175(4): 345 - 354.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. K. LeBlanc, B. M. Devereaux, T. F. Imperiale, K. Kesler, J. M. DeWitt, O. Cummings, D. Ciaccia, S. Sherman, P. Mathur, D. Conces, et al.
Endoscopic Ultrasound in Non-Small Cell Lung Cancer and Negative Mediastinum on Computed Tomography
Am. J. Respir. Crit. Care Med., January 15, 2005; 171(2): 177 - 182.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. K. LeBlanc, R. Espada, and G. Ergun
Non-small Cell Lung Cancer Staging Techniques and Endoscopic Ultrasound: Tissue Is Still the Issue
Chest, May 1, 2003; 123(5): 1718 - 1725.
[Abstract] [Full Text] [PDF]

Home page
 Eur J Cardiothorac SurgHome page
T. Sioris, R. Jarvenpaa, P. Kuukasjarvi, H. Helin, S. Saarelainen, and M. Tarkka
Comparison of computed tomography and systematic lymph node dissection in determining TNM and stage in non-small cell lung cancer
Eur J Cardiothorac Surg, March 1, 2003; 23(3): 403 - 408.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. G. Spiro and J. C. Porter
Lung Cancer--Where Are We Today?: Current Advances in Staging and Nonsurgical Treatment
Am. J. Respir. Crit. Care Med., November 1, 2002; 166(9): 1166 - 1196.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
N. Hollings and P. Shaw
Diagnostic imaging of lung cancer
Eur. Respir. J., April 1, 2002; 19(4): 722 - 742.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
J.A. Verschakelen, J. Bogaert, and W. De Wever
Computed tomography in staging for lung cancer
Eur. Respir. J., February 1, 2002; 19(35_suppl): 40S - 48s.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
British Thoracic Society, Society of Cardiothoracic Surgeons of Great Britai, and Ireland Working Party
Guidelines on the selection of patients with lung cancer for surgery
Thorax, February 1, 2001; 56(2): 89 - 108.
[Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. OST and A. FEIN
Evaluation and Management of the Solitary Pulmonary Nodule
Am. J. Respir. Crit. Care Med., September 1, 2000; 162(3): 782 - 787.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. Takizawa, M. Terashima, T. Koike, T. Watanabe, Y. Kurita, A. Yokoyama, and K. Honma
Lymph Node Metastasis In Small Peripheral Adenocarcinoma Of The Lung
J. Thorac. Cardiovasc. Surg., August 1, 1998; 116(2): 276 - 280.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
F. G. Gress, T. J. Savides, A. Sandler, K. Kesler, D. Conces, O. Cummings, P. Mathur, S. Ikenberry, S. Bilderback, and R. Hawes
Endoscopic Ultrasonography, Fine-Needle Aspiration Biopsy Guided by Endoscopic Ultrasonography, and Computed Tomography in the Preoperative Staging of Non-Small-Cell Lung Cancer: A Comparison Study
Ann Intern Med, October 15, 1997; 127(8_Part_1): 604 - 612.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. Takizawa and M. Terashima
Mediastinal lymph node metastasis in patients with clinical stage I lung cancer
J. Thorac. Cardiovasc. Surg., September 1, 1997; 114(3): 511 - 512.
[Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. Takizawa, M. Terashima, T. Koike, H. Akamatsu, Y. Kurita, and A. Yokoyama
MEDIASTINAL LYMPH NODE METASTASIS IN PATIENTS WITH CLINICAL STAGE I PERIPHERAL NON-SMALL-CELL LUNG CANCER
J. Thorac. Cardiovasc. Surg., February 1, 1997; 113(2): 248 - 252.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
H. Akamatsu, M. Terashima, T. Koike, T. Takizawa, and Y. Kurita
Staging of Primary Lung Cancer by Computed Tomography-Guided Percutaneous Needle Cytology of Mediastinal Lymph Nodes
Ann. Thorac. Surg., August 1, 1996; 62(2): 352 - 355.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
P. Goldstraw
Staging lung cancer with computed tomography
Ann. Thorac. Surg., February 1, 1991; 51(2): 345 - 345.
[PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1990 by The Society of Thoracic Surgeons.