Bronchogenic carcinoma: Utility of CT in the evaluation of patients with suspected lesions

PURPOSE: To assess the utility of computed tomography (CT) in the evaluation of suspected bronchogenic carcinoma. MATERIALS AND METHODS: CT scans were reviewed of 362 patients who had undergone CT for suspected bronchogenic carcinoma. RESULTS: CT findings of 275 patients were consistent with bronchogenic carcinoma. Sixty-five tumors were deemed unresectable on the basis of CT findings, 21 were deemed unresectable on the basis of CT findings and poor surgical risk, 26 proved to be benign, six were metastatic disease from an extrathoracic primary tumor, and 157 were potentially resectable bronchogenic carcinoma. Surgical mediastinal nodal sampling enabled documentation of metastases in 60 of 159 patients. According to nodal station, the sensitivity of CT for metastases was 67% for nodes measured in the long axis and 58% for nodes measured in the short axis; specificity was 56% and 86%, respectively. CONCLUSION: CT can be used to confirm or exclude the presence of bronchogenic carcinoma and to obviate thoracotomy. The specificity of CT is limited, and a histologic diagnosis or follow-up evaluation is necessary. CT has limited value in staging mediastinal lymph nodes.