Chest wall invasion by lung cancer is a significant local problem but not always established with certainty with use of chest computed tomography (chest CT). Transthoracic ultrasound (TTUS) is used increasingly frequently in the evaluation of chest disorders and provides excellent imaging of the chest wall. This study compares the ability of TTUS and CT of the chest in correctly assessing if chest wall invasion is present.PATIENTS AND METHODS: In a prospective study all consecutive patients who were found to have suspicion of chest wall invasion were enrolled in the study. All patients underwent a spiral CT and a TTUS. Patients who were operable candidates were then included in the study by comparing the actual pathology with imaging findings.
136 patients (83 male, 53 female, mean age 49.3y.) were examined with both methods. 90 pts (57male, 23 female, mean age 51.9 y.) were operated and evaluated. Reason for exclusion from surgery were: metastatic disease 12, N3-positive lymph nodes 7, neoadjuvante chemotherapy 10, other morbidities 6 and patients not consenting 1. 26 (29 %) of the 90 patients had chest wall invasion by tumor. The sensitivity of US was 89% and the specificity was 95%. The sensitivity of CT was 42% and the specificity was 100%. The accuracy of US and CT were 91% and 83%, respectively
TTUS is more accurate than chest CT in distinguishing infiltration of the chest wall by lung cancer.CLINICAL IMPLICATION: TTUS can be used assessing if chest wall invasion is present.
F.J. Herth, None.