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T. Hantrakul



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    P1.19 - Poster Session 1 - Imaging (ID 179)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Imaging, Staging & Screening
    • Presentations: 1
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      P1.19-011 - Correlation between the tumor size measured by using chest radiograph and CT chest comparison to the pathologic size (ID 3037)

      09:30 - 09:30  |  Author(s): T. Hantrakul

      • Abstract

      Background
      The size of the tumor is an important prognostic factor in cancer patient. It is ultimately based on the pathologic measurement of gross specimen from surgical resection. However, the preoperative tumor size could be determined by direct measurement of palpable superficial lesion or radiologic imaging such as chest radiograph or computed tomography (CT) in both lung window setting and mediastinal window setting. To our knowledge, there is no definite method to measure tumor’s size on radiographic imaging, moreover, the correlation between pulmonary tumor size measured by using radiographic imaging and pathologic size has not been studied in Thailand yet. The Northern Thailand Thoracic Group (NT-TOG) would like to determine the correlation between tumor size measured by using chest radiograph and CT chest comparison to the pathological tumor size.

      Methods
      After institutional review board approval, the retrospectively analytic cross sectional study from pathological records of all patients who underwent surgery in Chiang Mai University Hospital were reviewed. All cases that achieved CT imaging in the department of radiology were included. Finally 60 pulmonary tumors were collected to measure their sizes on chest radiograph and 98 pulmonary tumors were gather to measure their sizes on mediastinal and lung window sets and compared to the pathological sizes. The location of the tumor and histological cell type were recorded. Data analysis was performed using STATA software to find out the correlation between sizes that had been measured on chest radiograph and on CT images comparison to the tissue pathologic size.

      Results
      The tumor locations were common in the RUL and LUL. Adenocarcinoma was the most common histological type, followed by squamous cell carcinoma and metastasis respectively. The mean radiologic tumor sizes on chest radiograph, CT using mediastinal and lung window settings were 4.8 cm, 4.8 cm and 5.1 cm in maximal diameters, respectively. The mean pathologic tumor size was 4.7 cm in maximal diameter. The mean errors of chest radiographic measurement, CT measurement using mediastinal and lung window settings were 0.25 cm, 0.04 cm and 0.41 cm, respectively. The error of tumor size measured by using CT in mediastinal window setting was statistically significant less than that of using lung window setting (p<0.001). There was a statistically significant difference between tumor size measured by using CT in mediastinal window setting and pathologic tumor size (p<0.001). Predicted tumor size was calculated by using the equation “calculated tumor size (cm) = 1+(0.78xtumor size on CT in mediastinal window (cm)).

      Conclusion
      Although there is a statistically significant difference between CT measurement and pathologic tumor size, the tumor size measured by using CT in mediastinal window setting is seemly more accurate than in lung window setting or chest radiograph.