Abstract
One hundred forty-three patients with bronchogenic carcinoma were studied prospectively with computed tomography (CT) to determine the accuracy of CT in the evaluation of mediastinal nodal metastases. Mediastinal lymph nodes were localized according to the lymph node mapping scheme of the American Thoracic Society and were considered abnormal if they exceeded 1 cm in short-axis diameter. All patients underwent surgical staging, which consisted of either mediastinoscopy alone or mediastinoscopy and thoracotomy. At the time of surgical staging, all accessible nodes were either removed or sampled. The sensitivity of CT for mediastinal nodes on a perpatient basis was 64%, with a specificity of 62%. The sensitivity of CT for individual nodal stations involved with tumor was only 44%. The presence of obstructive pneumonitis did not appreciably alter the sensitivity of CT, but the specificity was lower (43%). The likelihood of metastases increased with lymph node size; however, seven of 19 (37%) lymph nodes that measured 2-4 cm in short-axis diameter were hyperplastic and did not contain metastases. The relative insensitivity of CT makes formal nodal sampling at the time of mediastinoscopy or thoracotomy essential to detect lymph node metastases.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 319-323 |
| Number of pages | 5 |
| Journal | Radiology |
| Volume | 182 |
| Issue number | 2 |
| State | Published - Feb 1992 |
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Keywords
- Lymphatic system, neoplasms, 67.337
- Mediastinum, CT, 67.1211
- Mediastinum, neoplasms, 67.3235
ASJC Scopus subject areas
- Radiological and Ultrasound Technology
Cite this
Bronchogenic carcinoma : Analysis of staging in the mediastinum with CT by correlative lymph node mapping and sampling. / McLoud, Theresa C.; Bourgouin, Pierre M.; Greenberg, Rona W.; Kosiuk, John P.; Templeton, Philip A.; Shepard, Jo Anne O; Moore, Elizabeth H; Wain, John C.; Mathisen, Douglas J.; Grillo, Hermes C.
In: Radiology, Vol. 182, No. 2, 02.1992, p. 319-323.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Bronchogenic carcinoma
T2 - Analysis of staging in the mediastinum with CT by correlative lymph node mapping and sampling
AU - McLoud, Theresa C.
AU - Bourgouin, Pierre M.
AU - Greenberg, Rona W.
AU - Kosiuk, John P.
AU - Templeton, Philip A.
AU - Shepard, Jo Anne O
AU - Moore, Elizabeth H
AU - Wain, John C.
AU - Mathisen, Douglas J.
AU - Grillo, Hermes C.
PY - 1992/2
Y1 - 1992/2
N2 - One hundred forty-three patients with bronchogenic carcinoma were studied prospectively with computed tomography (CT) to determine the accuracy of CT in the evaluation of mediastinal nodal metastases. Mediastinal lymph nodes were localized according to the lymph node mapping scheme of the American Thoracic Society and were considered abnormal if they exceeded 1 cm in short-axis diameter. All patients underwent surgical staging, which consisted of either mediastinoscopy alone or mediastinoscopy and thoracotomy. At the time of surgical staging, all accessible nodes were either removed or sampled. The sensitivity of CT for mediastinal nodes on a perpatient basis was 64%, with a specificity of 62%. The sensitivity of CT for individual nodal stations involved with tumor was only 44%. The presence of obstructive pneumonitis did not appreciably alter the sensitivity of CT, but the specificity was lower (43%). The likelihood of metastases increased with lymph node size; however, seven of 19 (37%) lymph nodes that measured 2-4 cm in short-axis diameter were hyperplastic and did not contain metastases. The relative insensitivity of CT makes formal nodal sampling at the time of mediastinoscopy or thoracotomy essential to detect lymph node metastases.
AB - One hundred forty-three patients with bronchogenic carcinoma were studied prospectively with computed tomography (CT) to determine the accuracy of CT in the evaluation of mediastinal nodal metastases. Mediastinal lymph nodes were localized according to the lymph node mapping scheme of the American Thoracic Society and were considered abnormal if they exceeded 1 cm in short-axis diameter. All patients underwent surgical staging, which consisted of either mediastinoscopy alone or mediastinoscopy and thoracotomy. At the time of surgical staging, all accessible nodes were either removed or sampled. The sensitivity of CT for mediastinal nodes on a perpatient basis was 64%, with a specificity of 62%. The sensitivity of CT for individual nodal stations involved with tumor was only 44%. The presence of obstructive pneumonitis did not appreciably alter the sensitivity of CT, but the specificity was lower (43%). The likelihood of metastases increased with lymph node size; however, seven of 19 (37%) lymph nodes that measured 2-4 cm in short-axis diameter were hyperplastic and did not contain metastases. The relative insensitivity of CT makes formal nodal sampling at the time of mediastinoscopy or thoracotomy essential to detect lymph node metastases.
KW - Lymphatic system, neoplasms, 67.337
KW - Mediastinum, CT, 67.1211
KW - Mediastinum, neoplasms, 67.3235
UR - http://www.scopus.com/inward/record.url?scp=0026564644&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0026564644&partnerID=8YFLogxK
M3 - Article
C2 - 1732943
AN - SCOPUS:0026564644
VL - 182
SP - 319
EP - 323
JO - Radiology
JF - Radiology
SN - 0033-8419
IS - 2
ER -