Detection and diagnosis of small peripheral lung cancers less than 15mm in diameter

Abstract

OBJECTIVE To assess the value of chest X-ray film, conventional CT (CCT), Spiral CT (SCT) and high resolution CT (HRCT) for detection and diagnosis of small peripheral lung cancers less than 15 mm in diameter. METHODS Chest X-ray film, CCT, SCT and HRCT were taken in 59 cases of peripheral lung cancers less than 15 mm in diameter confirmed by pathological examination following an operation. The value of these procedures for diagnosis was analyzed retrospectively. RESULTS In 47% of chest X-ray films and 17% of CCT, small lung cancers were not detected. However no tumor escaped detection by SCT. HRCT was superior for showing density and detailed image signs compared to chest films and CCT. The HRCT features of small peripheral lung cancers were quite different from those of larger peripheral lung cancers. CONCLUSION The SCT is the best method for detection, and HRCT for diagnosis of small peripheral lung cancers less than 15 mm in diameter. CT guided percutaneous transthoracic needle biopsy should be advocated.