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The Journal of Thoracic and Cardiovascular Surgery, Vol 94, 679-684, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
GA Patterson, RJ Ginsberg, PY Poon, JD Cooper, M Goldberg, D Jones, FG Pearson, TR Todd, P Waters and S Bull
Computed tomography, magnetic resonance imaging, chest roentgenography, and
mediastinoscopy were compared prospectively as staging modalities to assess
mediastinal node status in 84 patients with presumed operable bronchogenic
carcinoma. Computed tomography was associated with a sensitivity of 71.0%,
a specificity of 87.7% and an overall accuracy of 82.1%. Magnetic resonance
imaging did not provide any advantage over computed tomography in the
assessment of mediastinal node status. The accuracy of computed tomography
was not dependent on cell type of the primary tumor. Although chest
roentgenography had a sensitivity of 80.7%, the overall accuracy of 57.1%
was unacceptably low. The sensitivity (87.1%), specificity (100%), positive
(100%) and negative (93.0%) predictive values, and accuracy (95.2%) of
mediastinoscopy exceeded those observed with all other modalities. We
continue to recommend mediastinoscopy as the most accurate staging
investigation in the routine management of patients with bronchogenic
carcinoma.
ARTICLES
A prospective evaluation of magnetic resonance imaging, computed tomography, and mediastinoscopy in the preoperative assessment of mediastinal node status in bronchogenic carcinoma
Division of Thoracic Surgery, University of Toronto, Ontario, Canada.
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