Detection failures in spiral CT screening for lung cancer: Analysis of CT findings
Detection failures in spiral CT screening for lung cancer: Analysis of CT findings
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DOI：
10.1148/radiology.212.1.r99jn1461
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发表时间：
1999-07-01
期刊：
影响因子：
19.7
通讯作者：
Moriyama, N
中科院分区：
文献类型：
--
作者：
Kakinuma, R;Ohmatsu, H;Moriyama, N
目的：澄清计算机断层扫描 (CT) 结果以及在初次螺旋 CT 筛查时漏诊但后来发现的微小肺癌的进展。 材料和方法：对 7 名在初次螺旋 CT 筛查时漏诊的肺癌患者的检查结果进行了回顾。对回顾性 CT 结果、检测时间、细胞类型和病理分期进行了评估。 结果：早期螺旋 CT 漏诊的微小肺癌包括陈旧结核病阴影中的结节 (n = 2)、结节中心具有高衰减的微弱结节 (n = 1)、紧邻轴向周围肺血管 (n = 1) 和颅尾周围肺血管附近的衰减增加 (n = 1) 1) 和一个微小的微弱结节 (n = 2)。检测时间为 6 至 18 个月。病理检查发现，6 例癌症为 I 期，1 例为 II 期。结论：螺旋 CT 筛查可能会漏掉接近可检出阈值的肺癌微小结节。即使存在既往疾病（例如旧肺结核）的病变，也必须通过薄层 CT 检查非钙化结节，并仔细评估肺血管的阴影。强烈建议进行后续检查。
PURPOSE: To clarify the computed tomographic (CT) findings and the progression of minute lung cancers that were missed at initial spiral CT screening but were laterMATERIALS AND METHODS: The findings from seven patients with lung cancer that was missed at the initial spiral CT screening were reviewed. Retrospective CT findings, time to detection, cell type, and pathologic stage were evaluated.RESULTS: Minute lung cancers missed at early spiral CT included a nodule among the shadows of old tuberculosis (n = 2), a faint nodule with high attenuation in the center of the nodule (n = 1), an increase in attenuation just adjacent to an axial peripheral pulmonary vessel (n = 1) and adjacent to a craniocaudal peripheral pulmonary vessel (n = 1), and a minute faint nodule (n = 2). The time to detection ranged from 6 to 18 months. At pathologic examination, six cancers were stage I, and one was stage II.CONCLUSION: Minute nodules of lung cancer that are near the threshold of detectability may be missed at spiral CT screening. It is important to examine noncalcified nodules with thin-section CT even when lesions from prior disease, such as those from old tuberculosis, exist and to evaluate the shadows of pulmonary vessels carefully. A follow-up examination is highly recommended.