Pleural invasion by peripheral bronchogenic carcinoma: assessment with three-dimensional helical CT.

Abstract

To evaluate the potential role of three-dimensional (3D) computed tomography (CT) in assessment of pleural invasion by peripheral bronchogenic carcinoma. Twenty-four-second helical CT scans were obtained during a single breath hold in 42 consecutive patients with peripheral bronchogenic carcinoma. Conventional two-dimensional (2D) images and 3D reconstruction images were reviewed independently by three blinded observers, who reached a decision by consensus. All patients underwent surgical resection of the tumor, and CT findings were correlated with the findings in pathologic specimens. Twelve patients had visceral pleural invasion, five had parietal pleural invasion, and 25 had no evidence of pleural invasion. Visceral pleural invasion was identified on 2D CT images in two patients and on 3D reconstructions in 11. Parietal pleural invasion was identified on 2D CT images in two patients and on 3D reconstructions in three. 3D reconstruction imaging is superior to conventional 2D CT in assessment of pleural invasion by peripheral bronchogenic carcinoma.