Author of

• 10946

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

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Imaging, Staging & Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10957

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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 - 16:30  |  Author(s): Y. Wannasopha
    • 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.

• 11890

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  P2.19 - Poster Session 2 - Imaging (ID 180)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Imaging, Staging & Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11903

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    P2.19-013 - Pilot study of low dose computed tomography screening in first relative of lung cancer patient (preliminary report) (ID 3052)

    09:30 - 16:30  |  Author(s): Y. Wannasopha
    • Abstract

    Background
    Screening lung cancer with low dose computed tomography (CT) improved the likelihood of detection of small non-calcified nodules, and thus lung cancer might be detected earlier with more potential for a cure. The National Lung Screening Trial (NLST) showed that screening with low-dose helical computed tomography (CT) rather than with chest radiography reduced mortality from lung cancer. However, the cost-effectiveness of using low dose CT screening was still debatable in the normal population even in the smoking population. The Northern Thailand Thoracic Oncology Group (NT-TOG) would like to study focusing on the first relative of lung cancer patients which may benefit from low dose CT screening.

    Methods
    From January 2013 to May 2013, a prospective cohort study was performed at Chiang Mai University Hospital. We enrolled asymptomatic participants, 20 to 65 years of age who were the first relative of lung cancer patients and received a structural interview and informed consent. Low-dose CT scan and chest radiography were performed on the same day for each participant. Nodules or other suspicious findings were classified as positive results. Nodules or suspicious findings from either low-dose CT or chest radiography which have a high risk of malignancy will be worked up rapidly for tissue pathology whereas low risk nodules will be followed up with low-dose CT and chest radiography every six months, for two years. This study reports findings from the initial screening examination.

    Results
    There were 14 (45.2%) cases of positive nodule from low- dose CT screening out of a total of 31 cases, whereas, there were no positive nodules from the chest radiography. The average number of nodules was 2.1 nodules and the average size of nodule was 0.4 cm in diameter. There was ground-glass opacity (GGO) in seven cases (22.6 %), subsegmental atelectasis in 14 cases (45.2 %), traction bronchiectasis in four cases (12.9 %), and a lung cyst in one case with subcentimeter lymphadenopathy in 26 cases (83.9 %). The average size of the mediastinal lymph node was 0.7 cm in diameter (range 0.2-0.9 cm).

    Conclusion
    This study reported initial findings from low-dose CT and chest radiography. These results demonstrated that low-dose CT screen may be a valuable method for screening in the first relative of lung cancer patients compared with chest radiography. However, all of the positive cases need to be worked up for a definite tissue diagnosis in order to have an earlier diagnosis of lung cancer and potentially more curative treatment or at least to be closely monitored. This study will be continued and more participants will be recruited and evaluated.