Lung Cancer Staging and Management: Comparison of Contrast-enhanced and Nonenhanced Helical CT of the Thorax1
Edward F. Patz, Jr, MD,
Jeremy J. Erasmus, MD,
H. Page McAdams, MD,
John E. Connolly, MD,
Edith M. Marom, MD,
Philip C. Goodman, MD,
Richard A. Leder, MD,
Mary T. Keogan, MD and
James E. Herndon, PhD
1 From the Department of Radiology (E.F.P., J.J.E., H.P.M., J.E.C., E.M.M., P.C.G., R.A.L., M.T.K.) and Biometry Division, Community and Family Medicine (J.E.H.), Duke University Medical Center, Box 3808, Erwin Rd, Durham, NC 27710. Received May 20, 1998; revision requested June 18; final revision received September 2; accepted December 15. Address reprint requests to E.F.P. (e-mail: patz0002@mc.duke.edu).
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Figure 1a. CT scans obtained in a 76-year-old man with a 4-cm mass in the right upper lobe of the lung. (a) Nonenhanced axial CT scan demonstrates a 1.5-cm, aortopulmonary window (level 5) lymph node (arrow). (b) Contrast-enhanced axial CT scan obtained at approximately the same level as a demonstrates no substantial aortopulmonary window adenopathy. No abnormalities were seen on any of the adjacent images. This patient underwent mediastinoscopy and had a right paratracheal (level 4R) lymph node positive for metastatic disease; stage IIIA non–small cell lung cancer was diagnosed.
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Figure 1b. CT scans obtained in a 76-year-old man with a 4-cm mass in the right upper lobe of the lung. (a) Nonenhanced axial CT scan demonstrates a 1.5-cm, aortopulmonary window (level 5) lymph node (arrow). (b) Contrast-enhanced axial CT scan obtained at approximately the same level as a demonstrates no substantial aortopulmonary window adenopathy. No abnormalities were seen on any of the adjacent images. This patient underwent mediastinoscopy and had a right paratracheal (level 4R) lymph node positive for metastatic disease; stage IIIA non–small cell lung cancer was diagnosed.
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Figure 2a. CT scans in a 71-year-old woman with a lobular right hilar mass. (a) Nonenhanced axial CT scan through the liver was interpreted as normal. (b) Contrast-enhanced axial CT scan through the liver obtained at approximately the same level as a demonstrates a 4-mm-diameter, low-attenuating lesion (arrowhead) that was too small to characterize any further. No abnormalities were seen on any of the adjacent scans. This patient underwent mediastinoscopy; N2 positive nodes and thus stage IIIA non–small cell lung cancer was diagnosed. The low-attenuating lesion in the liver was believed to be benign, and there were no changes in patient management.
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Figure 2b. CT scans in a 71-year-old woman with a lobular right hilar mass. (a) Nonenhanced axial CT scan through the liver was interpreted as normal. (b) Contrast-enhanced axial CT scan through the liver obtained at approximately the same level as a demonstrates a 4-mm-diameter, low-attenuating lesion (arrowhead) that was too small to characterize any further. No abnormalities were seen on any of the adjacent scans. This patient underwent mediastinoscopy; N2 positive nodes and thus stage IIIA non–small cell lung cancer was diagnosed. The low-attenuating lesion in the liver was believed to be benign, and there were no changes in patient management.
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Copyright © 1999 by the Radiological Society of North America.
