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Accuracy of 16-channel multi-detector row chest computed tomography with thin sections in the detection of metastatic pulmonary nodules
Cited 47 time in
Web of Science
Cited 60 time in Scopus
- Authors
- Issue Date
- 2008-01-29
- Publisher
- Elsevier
- Citation
- Eur J Cardiothorac Surg. 2008 ;33(3):473-9.
- Keywords
- Adolescent ; Adult ; Aged ; Female ; Humans ; Lung Neoplasms/*radiography/*secondary/surgery ; Male ; Microtomy/*methods ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Radiographic Image Interpretation, Computer-Assisted ; Sensitivity and Specificity ; Solitary Pulmonary Nodule/*radiography/*secondary/surgery ; Tomography, X-Ray Computed/*methods ; Young Adult
- 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.
- ISSN
- 1010-7940 (Print)
- Language
- English
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