47P - Multi detector CT evaluation of suspicious malignant lung masses with its combined wash-in & wash-out features and their histopathological correlation

Abstract

Background: Lung cancer is the leading cause of cancer death in the world. Detection of malignancy at an early stage and with precision is the utmost objective of radiological evaluation. The final diagnosis of lung cancer is histopathological evaluation of the mass by biopsy or fine needle aspiration cytology (FNAC) only. This study was carried out with an aim of evaluating the suspected malignant masses by Multidetector CT (MDCT) along with their contrast wash-in & wash-out characterisctics with their histopathological correlation. Methods: After obtaining ethical approval, 50 cases of suspected lung cancer, by clinical and radiographic evaluation, were enrolled in the study. These patients underwent CT thorax (non contrast, contrast & delayed scans) on 384 slice Siemens Somatom Force®. After undergoing the radiological evaluation, biopsy of the mass was performed either using CT guidance or bronchoscopy guidance. Radiological and histopathological findings were correlated. Results: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of MDCT against histopathology were 97.3%, 76.9%, 92.3%, 90.9%, and 92.0%, respectively. Sensitivity and specificity calculated through receiver operating characteristic curve for wash-in (Net early enhancement) for >17.00 HU were found to be 97.3% and 76.9% while that of wash out characterization of lung mass - Relative wash-out at < 18.83% were 97.3% and 93.3%, and absolute washout at < 65.48% were 97.3% and 93.3% in predicting malignancy. Conclusions: MDCT serves as an excellent tool for early diagnosis of lung cancer and it is an important tool for cases where biopsy or FNAC is not possible. Faster and newer CT techniques such as contrast wash-in and wash out have greater diagnostic accuracy than the conventional diagnostic techniques. So a combination of conventional and newer techniques can further increase the diagnostic accuracy of MDCT in diagnosing lung cancers and obviate the need for invasive methods for biopsy/FNAC. Legal entity responsible for the study: Era's Lucknow Medical College & Hospital Funding: Era's Lucknow Medical College & Hospital Disclosure: All authors have declared no conflicts of interest.