Detection of Lung Cancer on Chest Radiographs: Analysis on the Basis of Size and Extent of Ground-Glass Opacity at Thin-Section CT

Abstract

To evaluate the detection of small peripheral lung tumors on chest radiographs on the basis of the size of the tumor and its extent of ground-glass opacity (GGO) at thin-section computed tomography (CT). Chest radiographs of 75 patients with peripheral carcinomas 20 mm in diameter or smaller (26 localized bronchioloalveolar carcinomas [BACs], 49 other carcinomas) and 60 normal chest radiographs were retrospectively reviewed individually by 10 radiologists. The extent of GGO within the lesions at thin-section CT was reviewed retrospectively. The detection rates for localized BAC and other carcinomas on chest radiographs were calculated and were correlated with tumor size and extent of GGO. The mean sensitivity for detection of small peripheral carcinomas was 58.5% +/- 8.8 (standard error) for localized BAC and was 78.6% +/- 5.1 for other carcinomas (P =.024). Lesions that were smaller than 15 mm in diameter and had an extent of GGO of 70% or greater at thin-section CT were more difficult to detect than tumors that had larger diameters or less extensive GGO (chi(2) = 8.13, df = 1, P =.004). The detection of small peripheral carcinomas on chest radiographs is influenced by tumor size and extent of GGO as seen at thin-section CT.