Agreement Between Computed Tomography and Pathologic Nodule Counts in Colorectal Lung Metastases

Area of Science:

• Oncology
• Radiology
• Surgical Pathology

Background:

• Computed tomography (CT) is standard for assessing pulmonary metastases and resectability.
• Discrepancies between CT and pathology can lead to suboptimal surgical outcomes.
• Accurate staging is crucial for effective colorectal cancer treatment.

Purpose of the Study:

• To quantify disagreement between CT-estimated and pathologically confirmed malignant lung lesions.
• To identify factors influencing discordance in pulmonary metastasectomy patients.

Main Methods:

• Multicenter longitudinal study utilizing a national registry.
• Analysis of patients undergoing open surgery for pulmonary metastasectomy.
• Comparison of radiologic findings with surgical pathologic results.

Main Results:

• Radiologic findings showed unilateral involvement in 85% and single nodules in 73% of patients.
• Overall concordance between CT and pathology was 78%.
• Bilateral involvement and higher nodule counts predicted discordance, with discrepancies rising sharply per additional nodule.

Conclusions:

• 1 in 5 patients exhibit discrepancies between radiologic and pathologic findings.
• High accuracy was observed for single pulmonary nodules.
• Discordance rates were substantial in patients with multiple nodules, impacting treatment decisions.