Diffuse lung disease: diagnostic accuracy of CT in patients undergoing surgical biopsy of the lung.

Abstract

To determine if there is a subset of patients undergoing surgical biopsy for diffuse lung disease in whom accurate diagnosis can be made with computed tomography (CT) only. Two chest radiologists retrospectively reviewed the CT scans of 85 patients in whom surgical biopsy for diffuse lung disease was performed. Thin-section CT images were available in 58 (68%) of the 85 cases. By consensus, the radiologists listed the three most likely diagnoses in order of probability and rated their level of confidence in the first choice. Each of 85 patients with diffuse lung disease had one of 16 diseases. In 79 (93%) cases, the correct diagnosis was one of the three choices. In 54 (64%) cases, the correct diagnosis was the radiologists' first choice. A high level of confidence in the first choice was reached in 20 (24%) cases; all 20 cases were forms of chronic lung disease. In 18 (90%) of these 20 cases, the first choice was correct. In a subset of patients with diffuse lung disease who undergo surgical biopsy, accurate diagnosis can be made with CT findings only.