Aim: In this study, the role of thorax-CT was examined in evaluating intrathoracic lymph node in patients diagnosed with preoperative NSCLC. The aim of this study is to review our existing knowledge on thorax-CT, which is the first examination used in evaluation of lung masses, and to discuss its performance in mediastinal staging based on data of patients in Turkey.
Materials and Methods: 510 cases selected in accordance with the criteria identified between January 2009 and July 2011 were included in the study. Lymph nodes, their sizes in thorax-CT, histological type of the tumour, removed mediastinal lymph nodes and pathology results were examined.
Results: As a result of the statistical analyses, sensitivity of thorax-CT in detecting metastatic intrathoracic lymph nodes was calculated as 75.7%, specificity 41%, NPV 85% and accuracy 48.4%. NPV and PPV were also calculated for N1 and N2 diseases. False positive rate of thorax-CT in detecting N1 disease was calculated as 53.6% and false negative rate was calculated 28.7%. False positive rate in detecting N2 disease was 64.6% and false negative rate was 20%.
Discussion: While thorax-CT is essential in mediastinal staging in NSCLC, we believe that it alone is not sufficient and needs to be supplemented with other scans and invasive methods. Due to the increased spending on health and time and labour spent due to the use of more than one scan, PET and CT should be used more frequently in especially in lung cancer.