Chest Wall Involvement by Lung Cancer

Thin-section Computed Tomography Based on Radiologic-Pathologic Correlation

Abstract

The aim of this retrospective study was to evaluate the role of conventional computed tomography (CT) findings and thin-section CT findings in predicting chest wall invasion by lung cancer, and the results of surgery according to the depth of chest wall involvement. We reviewed 33 patients with lung cancer adjacent to the pleural surface who underwent conventional CT scanning and subsequent thoracotomy. All the patients were examined with a TCT-900S, HELIX scanner (Toshiba, Tokyo) following bolus intravenous contrast medium administration (conventional: 60ml; thin-section: 40ml). The conventional CT images (taken at 10mm intervals with 10mm collimation) and thinsection CT images (taken at 2mm intervals with 2mm collimation) were reconst ructed employing an extended scale (window level: 40; window width: 400) using standard images.
A comparison of the diagnoses based on the thin-section CT findings and pathological examination findings showed thin-section CT to be 82% accurate for chest wall invasion compaired to 48% for conventional CT.
We conclude that thin-section CT is useful for the accurate evaluation of chest wall invasion in lung cancer, especially for patients in whom findings by conventional CT suggest possible tumor invasion of the chest wall.