TITLE

Accuracy of 16-channel multi-detector row chest computed tomography with thin sections in the detection of metastatic pulmonary nodules

AUTHOR(S)
Kang, Moon Chul; Kang, Chang Hyun; Lee, Hyun Ju; Goo, Jin Mo; Kim, Young Tae; Kim, Joo Hyun
PUB. DATE
March 2008
SOURCE
European Journal of Cardio-Thoracic Surgery;Mar2008, Vol. 33 Issue 3, p473
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objectives: The inaccuracy of conventional CT makes open thoracotomy and manual palpation inevitable in pulmonary metastasectomy. However, the introduction of multi-detector row CT technology made it possible to detect pulmonary nodules with a diameter of 1mm. The purpose of this study was to investigate the accuracy of 1mm thin-section 16-channel multi-detector row CT (TSMDCT) in the detection of metastatic pulmonary nodules. Methods: Twenty-seven patients who underwent pulmonary metastasectomy between November 2005 and September 2006 were included in the study. The primary tumors were colorectal cancer (n =11), renal cell carcinoma (n =5), osteosarcoma (n =3), hepatocellular carcinoma (n =3), thymic tumor (n =2), bladder cancer (n =1), thyroid cancer (n =1), and primitive neuroectodermal tumor (n =1). TSMDCT was performed in all patients in order to evaluate the location and number of metastatic nodules. The patients were divided into osteosarcoma and non-osteosarcoma groups, and the accuracy of TSMDCT was evaluated by comparison with the pathologic diagnosis of metastatic nodules. Results: A total of 117 nodules were detected preoperatively by TSMDCT scanning, and 198 nodules were resected during the operation. A total of 101 nodules were pathologically confirmed to be metastatic nodules. In the osteosarcoma group, the sensitivity, specificity, positive predictive value, and negative predictive value were 34%, 93%, 92%, and 38%, respectively. In the non-osteosarcoma group, the sensitivity, specificity, positive predictive value, and negative predictive value were 97%, 54%, 64%, and 96%, respectively. Subgroup analysis in the non-osteosarcoma group revealed that nodule size over 5mm, number of metastatic nodules less than five, and disease-free interval over 24 months showed 100% sensitivity by preoperative TSMDCT. Conclusions: TSMDCT with 1mm thickness image reconstruction showed high detection rate of metastatic pulmonary nodules in the patients with non-osteosarcoma. In highly selected subgroups, TSMDCT detected all the metastatic nodules which manual palpation could detect. Further study on the application of TSMDCT in thoracoscopic metastasectomy should be performed.
ACCESSION #
30018621

 

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