CT assessment of mediastinal invasion of bronchogenic carcinoma

Bronchogenic carcinoma is considered unresectable if the primary tumor involves certain mediastinal structures. The purpose of this paper is to determine the ability of CT to assess this involvement. The authors retrospectively reviewed the chest radiographs and CT scans of 75 patients with primary bronchogenic carcinoma who subsequently underwent mediastinoscopy and/or thoracotomy. From these 75 patients, 44 in whom the tumor mass was in contract with the mediastinum on chest radiograph were selected. The degree of contact of the tumor with each of 14 mediastinal structures was then assessed with Ct. Invasion was stated to be present when there was contact, with loss of the fat plane, with more than 90 degrees of the circumference of the structure; 90 or less was called uninvolved. Final assessment of each structure was determined at surgery, with pathologic proof, and was graded as follows: not assessed, not involved, involved but still resectable, or unresectable. One hundred seventy-three structures were assessed in these 44 patients, and 10 were found to be involved by tumor