Diagnostic Radiology

The most common reason for referral to a surgeon is the identification of a solitary pulmonary mass found on a chest radiograph. The most significant aid in the evaluation of a new pulmonary mass on chest radiograph is a previous chest radiograph for comparison. If the doubling time of the tumor is < 1 month it is likely infectious. If the doubling time is > 16 months it is likely to be benign. If the doubling time is between 1 and 16 months malignancy is more likely. Computed tomography (CT) is useful to determine the extent of tumor involvement and can detect enlarged lymph nodes. Lymph nodes > 1 cm have a 70% chance of being malignant. Without mediastinal node involvement, most patients are considered candidates for resection with a 5% false negative rate.

PET scan has emerged in recent years as a potential tool for distinguishing benign from malignant pulmonary nodules (Dewan). PET scanning has a sensitivity of 94% and a specificity of 80% in distinguishing benign from malignant pulmonary nodules.

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