Mediastinal nodes in bronchogenic carcinoma: Comparison between CT and mediastinoscopy using the American Thoracic Society node map

The authors compared CT and mediastinoscopy in 123 patients with bronchogenic carcinoma. All patients with negative mediastinoscopy had complete dissection of accessible nodes at thoracotomy. Nodal stations were defined by the American Thoracic Society mapping scheme. CT was as sensitive as mediastinoscopy (76%) in the detection of mediastinal metastases, but when the actual nodal stations with tumor were assessed, the sensitivity of CT dropped to 61%. Ninety percent of patients with false-negative mediastinoscopy but only 20% of patients with false-negative CT had surgically resectable disease. The authors conclude that mediastinoscopy is superior to CT in the preoperative assessment of mediastinal nodes