Diagnostic Accuracy Of Multidetector Computed Tomography (MDCT) In Evaluation Of Suspected Cases Of Carcinoma Lung In Comparison With Histopathology

Abstract

Introduction: Multidetector CT (MDCT), is the newest technological development that have revolutionized the diagnostic approach to diseases of the chest including lung cancer. MDCT will allow improved detection of pleural dissemination and hilar lymph node adenopathy because of the continuous and narrow scan collimation. It has considerable advantage over single-detector helical CT in the form of shorter acquisition time, greater coverage, and superior image resolution. Besides, it also has a role in characterizing them as benign or malignant. Hence the present study is aimed at evaluating the imaging characteristics and diagnostic accuracy of Carcinoma lung by 128-slice MDCT scanner, in comparison with histopathology. Methodology: A prospective observational study was conducted over a period of 22 months in all 46 patients referred to the Department of Radiodiagnosis for CT scan of chest during February 2022 to April 2023, with clinical/radiological suspicion of Carcinoma Lung after obtaining ethical committee clearance and written informed consent from patients. Purposive sampling method was used. Scanning was performed by a 128-slice CT scanner (Ingenuity CT; Philips Medical Systems, Best, the Netherlands). The Pre and Post contrast images were viewed and analysed by a single radiologist. Radiological diagnosis was compared histologically. Diagnostic accuracy of MDCT in diagnosis of bronchogenic carcinoma was calculated with pathological diagnosis as Gold standard P<0.05 was considered as statistically significant. Results: Study population included 28 males and 18 females. Mean age of study population was 61.61 years ± 11.7 years in the range of 38-82 years. Provisional CT diagnosis of Bronchogenic carcinoma was given in 46 patients of which 37 were positive on pathology. Of the 9 false positive cases, 8 cases are diagnosed as inflammatory infiltrate where as one case is diagnosed as metastasis from another site. Of the cases confirmed as bronchogenic carcinoma on pathology, 78.4 % had nodal involvement and 54% had metastasis at time of presentation. Diagnostic accuracy and Positive predictive value of MDCT in diagnosing bronchogenic carcinoma in our study is 80.4%. Conclusions: Multi Detector Computed Tomography has a high positive predictive value in diagnosis of bronchogenic carcinoma. MDCT is a useful tool in the staging of Bronchogenic Carcinoma. Staging is important in treatment planning and predicting outcome.