title: MSCT multi-criteria: a novel approach in assessment of mediastinal lymph node metastases in non-small cell lung cancer.
abstract: OBJECTIVE
  To evaluate the accuracy of multi-slice computed tomography (MSCT) in diagnosing mediastinal lymph node metastases in patients with non-small cell lung cancer (NSCLC) using a multi-criteria approach.
  
  
  METHODS
  We retrospectively reviewed contrast-enhanced MSCT of the chest in 86 consecutive patients with histopathologically proven NSCLC. All patients underwent surgical lymph node resection within 30 days from the CT examination. In all cases pathological and CT results were reviewed and correlated.
  
  
  RESULTS
  The sensitivity, specificity, positive and negative predictive values, and accuracy of MSCT using a multi-criteria approach in the detection of the N2 stage were 100%, 98.5%, 100%, 94.4% and 98.8% respectively, whereas using the size criterion alone 64%, 61%, 87%, 40%, and 62% respectively.
  
  
  CONCLUSIONS
  To improve MSCT accuracy for diagnosing N staging other criteria can be associated with lymph node size. The use of different dimensional cut-offs for each mediastinal lymph node station, the matching of positive nodal stations with tumour location, the structural characteristics and the type of enhancement allow for a high accuracy of MSCT in the staging of mediastinal nodes in NSCLC.
authors.affiliation: Department of Human Pathology and Oncology, Section of Radiological Sciences, University of Siena, Siena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Volterrani
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Mazzei
authors.forename: Benedetta
authors.initials: B
authors.lastname: Banchi
authors.forename: Luca
authors.initials: L
authors.lastname: Voltolini
authors.forename: Filomena
authors.initials: F
authors.lastname: La Sala
authors.forename: Salvatore Francesco
authors.initials: SF
authors.lastname: Carbone
authors.forename: Veronica
authors.initials: V
authors.lastname: Ricci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gotti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zompatori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012680:Sensitivity and Specificity