The value of computed tomography in staging bronchogenic carcinoma: a changing role for mediastinoscopy.
Forty-one patients underwent operative staging for bronchogenic carcinoma following computed tomography of the mediastinum between August, 1982, and March, 1984. Twenty-seven patients were classified as Stage I preoperatively; in 2 of them, positive mediastinal nodes were found at thoracotomy. For the 14 patients in whom positive nodes had been identified by computed tomographic (CT) scanning, staging was unchanged as a result of the findings at mediastinoscopy or thoracotomy or both. In this series, computed tomography had a sensitivity of 89%, a specificity of 100%, and an overall accuracy rate of 95%. We conclude that mediastinoscopy is not needed in patients without evidence of mediastinal nodal enlargement by CT scan; when performed, it should be guided toward those nodes identified as positive.
D002283:Carcinoma, Bronchogenic / Q000000981:diagnostic imaging* / Q000601:surgery; D005188:False Negative Reactions; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008220:Lymphography; D008481:Mediastinoscopy; D009367:Neoplasm Staging; D011012:Pneumomediastinum, Diagnostic; D014057:Tomography, X-Ray Computed