Diagnostic Performance and Imaging Features of Dual-Phase Contrast-Enhanced CT in Peripheral Lung Cancer: A...

BACKGROUND Peripheral lung cancer is characterized by an insidious onset and nonspecific early symptoms, resulting in delayed diagnosis and poor prognosis. Dual-phase contrast-enhanced computed tomography (CT) has potential advantages in visualizing tumor morphology and vascular characteristics; its diagnostic performance concerning pathological findings has not been fully elucidated. MATERIAL AND METHODS This prospective study included 120 patients with suspected peripheral lung cancer. All patients underwent dual-phase contrast-enhanced CT scanning; histopathological examination of biopsy or surgically resected specimens served as the reference standard. Patients were divided into 2 groups: lung cancer (n=81) and control (n=39). CT imaging features were compared between groups. The diagnostic performance of dual-phase contrast-enhanced CT was evaluated by calculating sensitivity, specificity, accuracy, positive likelihood ratio (PLR), and negative likelihood ratio (NLR), along with 95% confidence intervals. RESULTS Dual-phase contrast-enhanced CT demonstrated a sensitivity of 82.72%, specificity of 74.36%, accuracy of 80.00%, PLR of 3.23, and NLR of 0.23 for diagnosis of peripheral lung cancer. Histopathological examination confirmed 81 cases of peripheral lung cancer and 39 benign lesions. Peripheral lung cancer lesions-more frequently located in the right lung-were characterized by irregular shape, blurred margins, and spiculated margins. The incidences of vacuoles, contrast enhancement, vascular invasion, and lymph node metastasis were significantly higher in the lung cancer group than in the control group. CONCLUSIONS Dual-phase contrast-enhanced CT clearly demonstrated the malignant morphological and vascular characteristics of peripheral lung cancer, supporting use as a complementary noninvasive imaging modality for differential diagnosis of suspected peripheral lung cancer.