Abstract
Computerised tomography of the thorax has been in clinical use for almost a decade [1] and yet still we do not have a complete appreciation of its value in the surgical assessment of non small cell lung cancer. In the early years the cost of the equipment, at that time unproved, limited the availability of scanners and access to them. There was a need to develope the basic techniques and those of contrast enhancement. Clinicians and radiologists were learning together, often mesmerised by the detail shown by this technique, perhaps making interpretations without critical assessment. Where assessment was made, technological innovation often outstripped us, providing newer and faster scanners and making clinical studies obsolete before publication. The clinician caught in this technological maelstrom is only now regaining his balance and coming to appreciate that sophisticated technology cannot overcome the basic physical limitation of X-rays — they show densities, not histology. Armed with this basic cynicism, let us now look at what C.T. scans can tell us about the patient with presumed or proven non-small cell lung cancer (N.S.C.L.C.) being assessed for surgery.
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References
Sagel S, Stanley RJ, Evans RG: Early Clinical Experience with Motionless Whole-Body Computed Tomography. Radiology 119:321–330, 1976.
Staging of lung cancer, American Joint Committee for Cancer Staging and End Results Reporting: Task Force on Lung Cancer. Chicago, Illinois, 1979.
Woolner LB, Fontana RS, Sanderson DR et al.: Mayo Lung Project. Mayo Clin Proc 56:544–547, 1981.
Weiss W, Boucot KR, Seidman H: The Philadelphia Pulmonary Neoplasm Research Project. Clin Chest Med 3:243–256, 1982.
Dedrick CG: The Solitary Pulmonary Nodule and Staging of Lung Cancer. Clin Chest Med 5:345–363, 1984.
Siegelman SS, Zerhouni EA, Leo FP et al.: CT of the Solitary Pulmonary Nodule. AJR 135:1–13, 1980.
Godwin JD, Speckman JM, Fram EK et al.: Distinguishing Benign from Malignant Nodules by CT. Radiology 144:349–351, 1982.
Fink I, Gamsu G, Harter LP: CT Guided Aspiration Biopsy of the Thorax. J Comput Assist Tomogr 6:958–962, 1982.
Mintzer RA, Malave SR, Nelman HL et al.: Computed vs Conventional Tomography in Evaluation of Primary and Secondary Pulmonary Neoplasms. Radiology 132:653–659, 1979.
Modini C, Passariello R, Iascone C et al.: TNM Staging in Lung Cancer: Role of Computed Tomography. J Thorac Cardiovasc Surg 84:569–574, 1982.
Baron RL, Levitt RG, Sagel SS et al.: Computed Tomography in the Preoperative Evaluation of Bronchogenic Carcinoma. Radiology 145:727–732, 1982.
Friedman PJ, Feigin DS, Liston SE et al.: Sensitivity of Chest Radiography, Computed Tomography, and Gallium Scanning to Metastases of Lung Carcinoma. Cancer 54:1300–1306, 1984.
Piehler JM, Pairolero PC, Weiland LH et al.: Bronchogenic Carcinoma with Chest Wall Invasion: Factors Affecting Survival Following En Bloc Resection. Ann Thorac Surg 34:684–691, 1982.
Paulson DL: Carcinomas in the Superior Pulmonary Sulcus. J Thorac Cardiovasc Surg 70:1095–1102, 1975.
Pearson FG, Nelems JM, Henderson RD: The Role of Mediastinoscopy in the Selection of Treatment for Bronchial Carcinoma with Involvement of Superior Mediastinal Lymph Nodes. J Thorac Cardiovasc Surg 64:382–390, 1972.
Bowen TE, Zajtchuk R, Green DC et al.: Value of Anterior Mediastinotomy in Bronchogenic Carcinoma of the Left Upper Lobe. J Thorac Cardiovasc Surg 76:269–271, 1978.
Goldstraw P, Kurzer M, Edwards D: Preoperative Staging of Lung Cancer: Accuracy of Computed Tomography Versus Mediatinoscopy. Thorax 38:10–15, 1983.
Schnyder PA, Gamsu G: CT of the Pretracheal Retrocaval Space. AJR 136:303–308, 1981.
Struyven J: personal communication.
Ekholm S, Albrechtsson U, Kugelberg J et al.: Computed tomography in Preoperative Staging of Bronchogenic Carcinoma. J Comput Assit Tomogr 4:763–765, 1980.
Favez G, Willa C, Heinzer F: Posterior Oblique Tomography at an Angle of 55° in Chest Roentgenology. AJR 120:907–911, 1974.
McLoud TC, Wittenberg J, Ferrucci JT: Computed tomography of the Thorax and Standard Radiographic Evaluation of the Chest: A Comparative Study. J Comput Assist Tomogr 3:170–180, 1979.
Faling LF, Pugatch RD, Jung-Legg Y et al.: Computed Tomographic Scanning of the Mediastinum in the Staging of Bronchogenic Carcinoma. Am Rev Respir Dis 124:690–695, 1981.
Osborne DR, Korobkin M, Ravin CE et al.: Comparison of Plain Radiography, Conventional Tomography and Computed Tomography in Detecting Intrathoracic Lymph Node Metastases from Lung Carcinoma. Radiology 142:157–161, 1982.
Lewis JW, Madrazo BL, Gross SC et al.: The Value of Radiographic and Computed Tomography in the Staging of Lung Carcinoma. Ann Thorac Surg 34:553–558, 1982.
Webb WR, Glazer G, Gamsu G: Computed Tomography of the Normal Pulmonary Hilum. J Comput Assist Tomogr 5:476–484, 1981.
Webb WR, Gamsu G, Glazer G: Computed Tomography of the Abnormal Pulmonary Hilum. J Comput Assist Tomogr 5:485–490, 1981.
Crowe JK, Brown LR, Muhm JR: Computed Tomography of the Mediastinum. Radiology 128:75–87, 1978.
Cohen AM, Creviston S, Lipuma JP et al.: NMR Evaluation of Hilar and Mediastinal Lymphadenopathy. Radiology 148:739–742, 1983.
Moak GD, Cockerill EM, Färber MO et al.: Computed Tomography vs Standard Radiology in the Evaluation of Mediastinal Adenopathy. Chest 82:69–75, 1982.
Hirleman MT, Yiu-Chiu VS, Chiu LC et al.: The Resectability of Primary Lung Carcinoma: A Diagnostic Staging Review. CT 4:146–163, 1980.
Richardson JV, Zenk BA, Rossi NP: Preoperative Noninvasive Mediastinal Staging in Bronchogenic Carcinoma. Surgery 88:382–385, 1980.
Demeester TR, Golomb HM, Kirchner P et al.: The Role of Gallium-67 Scanning in the Clinical Staging and Preoperative Evaluation of Patients with Carcinoma of the Lung. Ann Thorac Surg 28:451–464, 1979.
Libshitz HI: CT of Mediastinal Lymph Nodes in Lung Cancer: Is There a ‘State of the Art?’ AJR 141:1081–1085, 1983.
Elliott JA: Preoperative Mediastinal Evaluation in Primary Bronchial Carcinoma — a Review of Staging Investigations. Postgrad Med J 60:83–91, 1984.
Friedman PJ: Computed Tomography in Lung Cancer. Am J Surg 143:685–690, 1982.
Webb WR: Advances in Computed Tomography of the Thorax. Radiol Clin N Am 21:723–739, 1983.
Somogyi JW: Computed Tomography of the Chest: Current Indications. J Med Assoc Ga 73:71–75, 1984.
Tan TD, Kuhler WJ, Taconis WK et al.: Computed Tomography Scanning of the Mediastinum in the Staging of Bronchogenic Carcinoma: A Prospective Radiologic and Pathologic Study. Acta Tuberc Pneumol Belg 70:343–352, 1979.
Rea HH, Shevland JE, House AJS: Accuracy of Computed Tomographic Scanning in Assessment of the Mediastinum in Bronchial Carcinoma. J Thorac Cardio vase Surg 81:825–829, 1981.
Shevland JE, House AJ, Rea HH: Computed Tomographic Assessment of the Mediastinum in Patients With Lung Cancer. Australas Radiol 27:240–245, 1983.
Richey HM, Matthews JI, Helzel RA et al.: Thoracic CT Scanning in the Staging of Bronchogenic Carcinoma. Chest 85:218–221, 1984.
Osborne DR, Korobkin M: Detection of Intrathoracic Lymph Node Metastases from Lung Carcinoma. (Letter). Radiology 144:187–188, 1982.
Glazer GM, Orringer MB, Gross BH et al.: The Mediastinum in Non-Small Cell Lung Cancer: CT-Surgical Correlation. AJR 142:1101–1105, 1984.
Breyer RH, Karstaedt N, Mills SA et al.: Computed Tomography for Evaluation of Mediastinal Lymph Nodes in Lung Cancer: Correlation with Surgical Staging. Ann Thorac Surg 38:215–220, 1984.
Pearson FG, Delarue NC, Ilves R et al.: Significance of Positive Superior Mediastinal Nodes Identified at Mediastinoscopy in Patients with Resectable Cancer of the Lung. J Thorac Cardiovasc Surg 83:1–11, 1982.
Hooper RG, Beechler CR, Johnson MC: Radioisotope Scanning in the Initial Staging of Bronchogenic Carcinoma. Am Rev Respir Dis 118:279–286, 1978.
Ramsdell JW, Peters RM, Taylor AT et al.: Multiorgan Scans for Staging Lung Cancer: Correlation with Clinical Evaluation. J Thorac Cardiovasc Surg 73:653–659, 1977.
Immerman SC, Vanecko RM, Fry WA et al.: Site of Recurrence in Patients with Stages I and II Carcinoma of the Lung Resected for Cure. Ann Thorac Surg 32:23–27, 1981.
Matthews MJ, Kanhouwa S, Pickren J et al.: Frequency of Residual and Metastatic Tumours in Patients Undergoing Curative Surgical Resection for Lung Cancer. Cancer Chem Rep 4:63–67, 1973.
Winstanley DP: Fruitless resections. (Abstract). Thorax 23:327, 1968.
Snow JH, Goldstein HM, Wallace S: Comparison of Scintigraphy, Sonography and Computed Tomography in The Evaluation of Hepatic Neoplasms. AJR 132:915–918, 1979.
Lusins JO, Chayes Z, Nakagawa H: Computed Tomography and Radionuclide Brain Scanning: Comparison in Evaluating Metastatic Lesions to Brain. NY Stat J Med 80:185–189, 1980.
Hooper RG, Tenholder MF, Underwood GH et al.: Computed Tomography Scanning of the Brain in Initial Staging of Bronchogenic Carcinoma. Chest 85:774–776, 1984.
Pagani JJ: Non-Small Cell Lung Carcinoma Adrenal Metastases: Computed Tomography and Percutaneous Needle Biopsy in Their Diagnosis. Cancer 53:1058–1060, 1984.
Nielsen ME, Heaston DK, Dunnick NR et al.: Pre-operative CT Evaluation of Adrenal Glands in Non-Small Cell Bronchogenic Carcinoma. AJR 139:317–320, 1982.
Chapman GS, Kumar D, Redmond J et al.: Upper Abdominal CT Scanning in Staging Non-Oat Cell Lung Carcinoma. (Letter). N Engl J Med 15:189, 1982.
Sandler MA, Pearlberg KL, Madrazo BL et al.: Computed Tomographic Evaluation of The Adrenal Gland in the Preoperative Assessment of Bronchogenic Carcinoma. Radiology 145:733–736, 1982.
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© 1986 Martinus Nijhoff Publishers, Boston
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Goldstraw, P. (1986). C.T. Scanning in the Pre-Operative Assessment of Non-Small Cell Lung Cancer. In: Hansen, H.H. (eds) Lung Cancer: Basic and Clinical Aspects. Cancer Treatment and Research, vol 28. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2295-5_10
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DOI: https://doi.org/10.1007/978-1-4613-2295-5_10
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