Technical accuracy and clinical efficacy of thoracic computed tomography

The technical accuracy and clinical efficacy of thoracic CAT scans in 302 surgical patients were retrospectively reviewed. We conclude that thoracic CAT scans should be ordered selectively since the technical accuracy of existing radiographic studies in detecting disease is equally high (greater than 90 percent) and the clinical efficacy does not differ substantially (less than 16 percent). The accuracy of CAT scans in staging carcinoma (the extent of the lesion or nodes) is only 58 percent. The technical limitations of these scans include (1) a lack of specificity because of the high incidence of false-positive lymph nodes, (2) a low or unreliable yield from needle aspiration, and (3) unreliable findings due to altered anatomy by previous treatment or associated disease. Surgical treatment regarding operability and resectability should not be solely based on CAT scans. These scans appear to be a useful screening test for chronic vascular disease and localization of obscure thoracic infections.