Chest wall and mediastinal invasion by lung cancer: evaluation with multisection expiratory dynamic CT.

Abstract

To assess the utility of multisection expiratory dynamic (ED) computed tomography (CT) in evaluation of tumor invasion in the chest wall or mediastinum. Fifteen patients with lung cancer underwent multisection ED CT. At each section level, 10 images were obtained at an interval of 1 second during a single expiratory maneuver. These images were evaluated in cine mode to assess tumoral movement along the chest wall or mediastinum. ED CT showed that the tumors in five patients were fixed to the chest wall (n = 2) or mediastinum (n = 3); free movement of tumor along the peripheral (n = 7) or mediastinal (n = 3) pleura was proved in the 10 other patients. At pathologic examination, the ED CT findings were proved correct in all patients. In six patients, ED CT provided additional information about tumor invasion that could not be obtained with conventional criteria. Multisection ED CT may improve the accuracy of CT in prediction of chest wall or mediastinal invasion of lung cancer.