Small peripheral lung carcinoma evaluated with incremental dynamic CT: radiologic-pathologic correlation.

Abstract

To correlate incremental dynamic computed tomographic (CT) and pathologic findings in peripheral lung cancer. Lung lesions smaller than 3 cm in diameter were evaluated in 18 patients. CT values of the inner area of the nodule at plain CT and at 30 seconds, 2 minutes, and 5 minutes after administration of nonionic contrast material were calculated with incremental dynamic CT. Maximum attenuation was compared with pathologic type of lung carcinoma and with number of vessels and distribution of elastic fibers in the pathologic specimen. Enhancement of all lesions was statistically significant (P < .0001). Maximum attenuation of lung carcinomas correlated positively with number of small vessels (diameter, 0.02-0.10 mm) (r = .77). Distribution of elastic fibers in the tumoral interstitium correlated with maximum attenuation (P = .04 between grades 1 and 3) and with number of small vessels (P = .01 between grades 1-3; P = .008 between grades 1 and 3). Enhancement characteristics of lung carcinomas reflect the number of small tumoral vessels and the distribution of elastic fibers in the tumoral interstitium.