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Research Article| Volume 9, ISSUE 1, P21-32, January 1985

Improving specificity of computed tomography in diagnosis of malignant mediastinal lymph nodes

  • David S. Feigin
    Correspondence
    Address reprint request to: David S. Feigin, MD, Department of Radiology (V-114), University of California, San Diego, La Jolla, California 92093.
    Affiliations
    From the Departments of Radiology, Pathology, and Surgery, Veterans Administration Medical Center, La Jolla; and the University of California, San Diego Medical Center, San Diego, California, USA
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  • Paul J. Friedman
    Affiliations
    From the Departments of Radiology, Pathology, and Surgery, Veterans Administration Medical Center, La Jolla; and the University of California, San Diego Medical Center, San Diego, California, USA
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  • Steven E. Liston
    Affiliations
    From the Departments of Radiology, Pathology, and Surgery, Veterans Administration Medical Center, La Jolla; and the University of California, San Diego Medical Center, San Diego, California, USA
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  • Parviz Haghighi
    Affiliations
    From the Departments of Radiology, Pathology, and Surgery, Veterans Administration Medical Center, La Jolla; and the University of California, San Diego Medical Center, San Diego, California, USA
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  • Richard M. Peters
    Affiliations
    From the Departments of Radiology, Pathology, and Surgery, Veterans Administration Medical Center, La Jolla; and the University of California, San Diego Medical Center, San Diego, California, USA
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  • Jonathan G. Hill
    Affiliations
    From the Departments of Radiology, Pathology, and Surgery, Veterans Administration Medical Center, La Jolla; and the University of California, San Diego Medical Center, San Diego, California, USA
    Search for articles by this author
DOI:https://doi.org/10.1016/0149-936X(85)90046-3
Improving specificity of computed tomography in diagnosis of malignant mediastinal lymph nodes
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      Abstract

      Four parameters of lymph node appearance on computed tomography were studied to improve specificity for malignancy in bronchogenic carcinoma: 1) node location, 2) homogeneity, 3) border definition, and 4) delineation by fat. Of 54 carcinoma patients, nodes were pathologically malignant in 21. Computed tomography showed enlarged nodes (over 1 cm) in 20 of these (true-positive rate, 96%), but also in 13 of the 33 patients with pathologically benign lymph nodes (false-positive rate, 39%). A combination of all four computed tomography parameters reduced the false-positive rate from 39 to 21% and decreased the true-positive rate from 96 to 86%. The criterion of border definition alone reduced the false-positive rate from 39 to 6%, but decreased the true-positive rate from 96 to 61%. The most useful computed tomography parameter was delineation, which reduced the false-positive rate to 15% and decreased the true-positive rate only to 86%. The computed tomography appearance of enlarged lymph nodes may be used to improve selection of patients with enlarged nodes for preoperative biopsy.

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      Article info

      Identification

      DOI: https://doi.org/10.1016/0149-936X(85)90046-3

      Copyright

      © 1985 Published by Elsevier Inc.

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