47P - Multi detector CT evaluation of suspicious malignant lung masses with its combined wash-in & wash-out features and their histopathological correlation

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Imaging, Diagnosis and Staging
Lung and other Thoracic Tumours
Presenter Sachin Khanduri
Citation Annals of Oncology (2017) 28 (suppl_2): ii14-ii16. 10.1093/annonc/mdx086
Authors S. Khanduri, S. Bhagat
  • Radiodiagnosis, Era's Lucknow Medical College & Hospital, 226003 - Lucknow/IN

Abstract

Background

Lung cancer is the leading cause of cancer death in the world. Detection of malignancy at an early stage and with precision is the utmost objective of radiological evaluation. The final diagnosis of lung cancer is histopathological evaluation of the mass by biopsy or fine needle aspiration cytology (FNAC) only. This study was carried out with an aim of evaluating the suspected malignant masses by Multidetector CT (MDCT) along with their contrast wash-in & wash-out characterisctics with their histopathological correlation.

Methods

After obtaining ethical approval, 50 cases of suspected lung cancer, by clinical and radiographic evaluation, were enrolled in the study. These patients underwent CT thorax (non contrast, contrast & delayed scans) on 384 slice Siemens Somatom Force®. After undergoing the radiological evaluation, biopsy of the mass was performed either using CT guidance or bronchoscopy guidance. Radiological and histopathological findings were correlated.

Results

Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of MDCT against histopathology were 97.3%, 76.9%, 92.3%, 90.9%, and 92.0%, respectively. Sensitivity and specificity calculated through receiver operating characteristic curve for wash-in (Net early enhancement) for >17.00 HU were found to be 97.3% and 76.9% while that of wash out characterization of lung mass - Relative wash-out at < 18.83% were 97.3% and 93.3%, and absolute washout at < 65.48% were 97.3% and 93.3% in predicting malignancy.

Conclusions

MDCT serves as an excellent tool for early diagnosis of lung cancer and it is an important tool for cases where biopsy or FNAC is not possible. Faster and newer CT techniques such as contrast wash-in and wash out have greater diagnostic accuracy than the conventional diagnostic techniques. So a combination of conventional and newer techniques can further increase the diagnostic accuracy of MDCT in diagnosing lung cancers and obviate the need for invasive methods for biopsy/FNAC.

Clinical trial identification

Legal entity responsible for the study

Era\'s Lucknow Medical College & Hospital

Funding

Era\'s Lucknow Medical College & Hospital

Disclosure

All authors have declared no conflicts of interest.