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Detection of Lung Cancer on Chest Radiographs: Analysis on the Basis of Size and Extent of Ground-Glass Opacity at Thin-Section CT¹

¹ From the Department of Diagnostic Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan (M.T., K.K., J.A., C.K.); Department of Computer Science and Systems Engineering, Yamaguchi University, Japan (S.K.); Department of Radiology, Osaka Chuo Hospital, Japan (N.K.); and Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan (M.T., T.J., N.T., O.H.). Received August 25, 2000; revision requested October 14; final revision received September 20, 2001; accepted December 11. Address correspondence to M.T. (e-mail: tubamoto@radiol.med.osaka-u.ac.jp).

PURPOSE: To evaluate the detection of small peripheral lung tumors on chest radiographs on the basis of the size of the tumor and its extent of ground-glass opacity (GGO) at thin-section computed tomography (CT).

MATERIALS AND METHODS: Chest radiographs of 75 patients with peripheral carcinomas 20 mm in diameter or smaller (26 localized bronchioloalveolar carcinomas [BACs], 49 other carcinomas) and 60 normal chest radiographs were retrospectively reviewed individually by 10 radiologists. The extent of GGO within the lesions at thin-section CT was reviewed retrospectively. The detection rates for localized BAC and other carcinomas on chest radiographs were calculated and were correlated with tumor size and extent of GGO.

RESULTS: The mean sensitivity for detection of small peripheral carcinomas was 58.5% ± 8.8 (standard error) for localized BAC and was 78.6% ± 5.1 for other carcinomas (P = .024). Lesions that were smaller than 15 mm in diameter and had an extent of GGO of 70% or greater at thin-section CT were more difficult to detect than tumors that had larger diameters or less extensive GGO (² = 8.13, df = 1, P = .004).

CONCLUSION: The detection of small peripheral carcinomas on chest radiographs is influenced by tumor size and extent of GGO as seen at thin-section CT.

© RSNA, 2002

Index terms: Lung, ground-glass opacification, 60.32 • Lung neoplasms, CT, 60.12118 • Lung neoplasms, diagnosis, 60.32

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