Chest wall invasion by lung cancer: limitations of CT evaluation

• Published in: American journal of roentgenology (1976) Vol. 144; no. 3; pp. 507 - 511
• Main Authors: Pennes, DR, Glazer, GM, Wimbish, KJ, Gross, BH, Long, RW, Orringer, MB
• Format: Journal Article
• Language: English
• Published: United States Am Roentgen Ray Soc 01.03.1985
• Subjects: Adult; Aged; Female; Humans; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Male; Middle Aged; Neoplasm Invasiveness; Retrospective Studies; Thoracic Neoplasms - diagnostic imaging; Thoracic Neoplasms - pathology; Tomography, X-Ray Computed
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/ajr.144.3.507

Thirty-three patients with peripheral pulmonary malignancies contiguous with a pleural surface were evaluated for chest wall invasion by computed tomography (CT). CT criteria included pleural thickening adjacent to the tumor, encroachment on or increased density of the extrapleural fat, asymmetry of the extrapleural soft tissues adjacent to the tumor, apparent mass invading the chest wall, and rib destruction. The CT scans were classified as positive, negative, or equivocal for invasion, and a decision matrix was constructed comparing CT results with pathologic data. The sensitivity of CT was 38%, specificity was 40%, and accuracy was 39% for evaluation of invasion if equivocal CT results were counted as radiologic errors. CT scanning has low accuracy in assessing chest wall invasion in patients with peripheral lung cancers.