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This Article Full Text (PDF) All Versions of this Article: chest.07-1656v1 133/4/881    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bandi, V. Articles by Herth, F. J. Search for Related Content PubMed PubMed Citation Articles by Bandi, V. Articles by Herth, F. J. Related Content Related Editorial

Ultrasound vs. Computed Tomography in Detecting Chest Wall Invasion by Tumor: A Prospective Study

Venkata Bandi MD, vbandi@bcm.tmc.edu, Baylor College of Medicine, Houston, TX.; William Lunn MD, wlunn@bcm.tmc.edu, Baylor College of Medicine, Houston, TX.; Armin Ernst MD, aernst@bidmc.harvard.edu, Beth Israel Deaconess Medical Center, Boston, MA; Ralf Eberhardt MD, r.eberhardt@thoraxklinik-heidelberg.edu, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.; Hans Hoffmann MD, h.hoffmann@thoraxklinik-heidelberg.edu, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.; Felix JF Herth MD, f@herth.net, Thoraxklinik, University of Heidelberg, Heidelberg, Germany

wlunn{at}bcm.tmc.edu

Abstract

BackgroundLung cancer is one of the leading causes of cancer related deaths worldwide. Accurate staging is important for patient management and clinical research. 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 scan, MRI and ultrasound examination. The purpose of this study is to evaluate the sensitivity and specificity of ultrasound examination in determining chest wall involvement of lung cancer compared to that of CT scan and surgery.

Methods136 patients with clinical suspicion of chest wall involvement were recruited. 90 patients met inclusion criteria and underwent CT scan, transthoracic ultrasound and surgical exploration. Final determination regarding chest wall involvement was made after reviewing final pathology and surgical staging.

ResultsChest wall invasion by tumor was noted in 26 patients during surgery and final pathological examination of the tissue. Of these ultrasound correctly identified 23 patients, while CT scan identified 11 patients with tumor invasion. There were 3 false positives and 3 false negatives with ultrasound examination compared to 15 false negatives and no false positive results with CT scan.

ConclusionsUltrasound has better sensitivity (89%) and specificity (95%) assessing chest wall involvement by lung tumor compared to CT scan examination (sensitivity 42%; specificity 100%).

Key Words: Lung cancer • Staging • CAT scan • Ultrasound • Surgery

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Ultrasound: The Pulmonologist’s New Best Friend

Momen M. Wahidi
Chest 2008 133: 836-837. [Full Text] [PDF]

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				M. M. Wahidi Ultrasound: The Pulmonologist's New Best Friend Chest, April 1, 2008; 133(4): 836 - 837. [Full Text] [PDF]