Computed tomography in the evaluation of tumor regression after neoadjuvant therapy: X-ray surgery and X-ray morphological comparisons
Kuznetsova, T.A.; Moiseev, P.I.
Vestnik Rentgenologii i Radiologii 3: 32-36
2004
ISSN/ISBN: 0042-4676 PMID: 15587881 Document Number: 580798
An analysis was made of chest computed tomograms of 38 small-cell lung cancer patients subjected to radical surgical treatment after neoadjuvant therapy. CT data were compared with the findings of macro- and microscopic examination of surgical specimens. In 24 (63.2%) patients, computed tomograms made before surgery showed complete tumor response confirmed by gross examination in 22 (96.1%) of them. However, microscopic examination found cancer cells in 8 (33.3%) patients. In 2 (8.3%) patients, small residual tumors could be detected by sight, which was confirmed by pathological examination. In 14 (36.8%) patients with partial response, radiological and gross examination findings fully coincided. Nevertheless, in 2 (14.3%) cases the "residual tumor" appeared to be a segment of fibrocicatrical tissue under pathological examination. On the basis of the CT findings the values of diagnostic sensitivity, accuracy and specificity in tumor response evaluation were calculated which made up 87.5%, 68.4% and 54.5% respectively. With sufficiently high sensitivity, CT specificity is low. CT makes it possible to objectively define the response of small-cell lung cancer to neoadjuvant therapy. However, the conclusion about complete response to the treatment can be made only on the basis of a comprehensive evaluation of the results of all available investigation methods and pathological examination.