title: CT staging of colorectal cancer: what do you find in the chest?
abstract: OBJECTIVE
  To clarify the chest computed tomography (CT) findings in patients with a new diagnosis of colorectal adenocarcinoma.
  
  
  METHODS
  Patients diagnosed with colorectal cancer (CRC) over a 3-year period were retrospectively studied. All CT examinations were performed within a single NHS Trust using the same CT system and protocol. Two primary outcomes were assessed: the presence of pulmonary metastases and the identification of a significant, unexpected chest abnormality.
  
  
  RESULTS
  Five hundred and fourteen out of 568 (90.5%) CRC patients underwent complete CT staging. Thirty-one patients (6%) had lung metastases, of which four (0.8%) were isolated. Three hundred and fifty-three (68.7%) had no evidence of pulmonary metastases, but 130 (25.3%) had indeterminate lung nodules (ILNs). The ILNs of 12 patients were subsequently confirmed as metastases on follow-up. A major non-metastatic finding (pulmonary embolism or synchronous primary malignancy) was found in 15/514 patients (3%).
  
  
  CONCLUSIONS
  Thoracic CT altered the initial TNM stage in fewer than 1% of CRC patients, but the detection of significant incidental chest disease and the establishment of an imaging baseline are useful outcomes of this imaging strategy. One-quarter of all staging examinations demonstrated ILNs.
authors.affiliation: Department of Radiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom. andrewmcqueen7@hotmail.com
authors.forename: A S
authors.initials: AS
authors.lastname: McQueen
authors.forename: J
authors.initials: J
authors.lastname: Scott
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed