CT Evaluation for Clinical Lung Cancer Staging: Do Multiplanar Measurements Better Reflect Pathologic T-Stage than Axial Measurements?

To retrospectively investigate whether tumor size assessment on multiplanar reconstruction (MPR) CT images better reflects pathologic T-stage than evaluation on axial images and evaluate the additional value of measurement in three-dimensional (3D) space. From 1661 patients who had undergone surgical resection for primary lung cancer between June 2013 and November 2016, 210 patients (145 men; mean age, 64.4 years) were randomly selected and 30 were assigned to each pathologic T-stage. Two readers independently measured the maximal lesion diameters on MPR CT. The longest diameters on 3D were obtained using volume segmentation. T-stages determined on CT images were compared with pathologic T-stages (overall and subgroup-Group 1, T1a/b; Group 2, T1c or higher), with differences in accuracy evaluated using McNemar's test. Agreement between readers was evaluated with intraclass correlation coefficients (ICC). The diagnostic accuracy of MPR measurements for determining T-stage was significantly higher than that of axial measurement alone for both reader 1 (74.3% [156/210] vs. 63.8% [134/210]; Size measurement on MPR CT better reflected the pathological T-stage, specifically for T1c or higher stage lung cancer. Measurements in a 3D plane showed no added value.

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Copyright © 2019 The Korean Society of Radiology.

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The authors have no potential conflicts of interest to disclose.