Ultrasound vs. CT in detecting chest wall invasion by tumor: a prospective study.
BACKGROUND
Lung cancer is one of the leading causes of cancer-related deaths worldwide. Accurate staging is important for patient management and clinical research. The recognition of chest wall involvement preoperatively is important for staging and surgical planning. Multiple modalities are available to assess the chest wall involvement preoperatively, including CT scanning, MRI, and ultrasound (US) examination. The purpose of this study was to evaluate the sensitivity and specificity of the US examination in determining the chest wall involvement of lung cancer compared to that of CT scan and surgery.


METHODS
A total of 136 patients with clinical suspicion of chest wall involvement were recruited. Ninety patients met the inclusion criteria and underwent CT scanning, transthoracic US, and surgical exploration. A final determination regarding chest wall involvement was made after reviewing the final pathology results and surgical staging.


RESULTS
Chest wall invasion by tumor was noted in 26 patients during surgery and final pathologic examination of the tissue. Of these patients, US correctly identified 23 patients tumor invasion, while CT scanning identified 11 patients with tumor invasion. There were 3 false-positive results and 3 false-negative results with US examination, compared to 15 false-negative results and no false-positive results with CT scanning.


CONCLUSIONS
US has better sensitivity (89%) and specificity (95%) in assessing chest wall involvement by a lung tumor compared to CT scan examination (sensitivity, 42%; specificity, 100%).
Bandi
Venkata
V
Interventional Pulmonary, Baylor College of Medicine, Houston, TX 77030, USA.
Lunn
William
W
Ernst
Armin
A
Eberhardt
Ralf
R
Hoffmann
Hans
H
Herth
Felix J F
FJ
D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging / Q000379:methods; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D035441:Thoracic Wall / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography