European Radiology: Seeing is not necessarily true: CT images of patients with severe emphysema may underestimate the true size of the tumor!

Since T TNM staging of lung cancer staging it is mainly determined by the size of the tumor, and therefore accurate measurement of the size of the tumor before for accurate preoperative staging is crucial in the CT image
.

For TNM stage, although the International Association for the Study of lung cancer (IASLC) recommended the use of CT image multiplanar reconstruction (MPR) preoperative lung were solid nodule size, but currently the best method for measuring other types of lung cancer yet Consensus

Since T TNM staging of lung cancer staging it is mainly determined by the size of the tumor, and therefore accurate measurement of the size of the tumor before for accurate preoperative staging is crucial in the CT image

On the other hand, emphysema is a well-known risk factor for lung cancer

As far as we know, there is no research to investigate the influence of the presence or absence of emphysema on the measurement of tumor size on CT images

In this study, the patients with primary lung cancer surgery in the image and pathological findings

In emphysema, CT axial position a mean diameter significantly smaller than the average diameter of the pathology ( read reader 1/2 P = 0.

 

FIG axial position and the measured diameter of the tumor on the image MPR CT .
a57-year-old male of adenocarcinoma of the axial images, b is the sagittal reconstruction image .
c75-year-old male of axial images of the squamous cell carcinoma, emphysema background, d is reconstructed sagittal image .
Then, in the sagittal bit image maximum diameter measured again and the measured axial and sagittal images maximum large diameter as the diameter measurement MPR CT image .
On the pathological specimen, the diameter of the tumors shown in a and b is 22 mm, and the diameter of the tumors shown in c and d is 19 mm .
 

FIG axial position and the measured diameter of the tumor on the image MPR CT .

a57-year-old male of adenocarcinoma of the axial images, b is the sagittal reconstruction image .
c75-year-old male of axial images of the squamous cell carcinoma, emphysema background, d is reconstructed sagittal image .
Then, in the sagittal bit image maximum diameter measured again and the measured axial and sagittal images maximum large diameter as the diameter measurement MPR CT image .
On the pathological specimen, the diameter of the tumors shown in a and b is 22 mm, and the diameter of the tumors shown in c and d is 19 mm .
FIG axial position and the measured diameter of the tumor on the image MPR CT .
a57-year-old male of adenocarcinoma of the axial images, b is the sagittal reconstruction image .
c75-year-old male of axial images of the squamous cell carcinoma, emphysema background, d is reconstructed sagittal image .
Then, in the sagittal bit image maximum diameter measured again and the measured axial and sagittal images maximum large diameter as the diameter measurement MPR CT image .
On the pathological specimen, the diameter of the tumors shown in a and b is 22 mm, and the diameter of the tumors shown in c and d is 19 mm .
 

Compared with patients without emphysema, severe emphysema patients before surgery CT on the measured tumor size is significantly smaller, in particular a tumor larger volume in the case of particularly significant
.

Therefore, this study suggests that when selecting the T staging of patients with severe emphysema , the widest three-dimensional MPR should be used for measurement to reduce the generation of errors

Compared with patients without emphysema, severe emphysema patients before surgery CT on the measured tumor size is significantly smaller, in particular a tumor larger volume in the case of particularly significant

Original source :

Haruto Sugawara , Hirokazu Watanabe , Akira Kunimatsu ,et al .

Tumor size in patients with severe pulmonary emphysema might be underestimated on preoperative CT.
DOI: 10.
1007/s00330-021-08105-3

Sugawara Haruto Hirokazu Watanabe Akira Kunimatsu , et Al 10.
1007 / s00330-021-08105-3 10.
1007 / s00330-021-08105-3 in this message