Katharine Lampen-Sachar MD, Presenter: Nothing to Disclose

Binsheng Zhao DSc, Abstract Co-Author: Nothing to Disclose

Maureen F Zakowski MD, Abstract Co-Author: Nothing to Disclose

Lawrence H. Schwartz MD, Abstract Co-Author: Research, General Electric Company Research Consultant, Novartis AG Research grant, AstraZeneca PLC

Naiyer A Rizvi, Abstract Co-Author: Nothing to Disclose

Mark G. Kris MD, Abstract Co-Author: Nothing to Disclose

Michelle Segall Ginsberg MD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

To compare preoperative size of Stage I or II Non Small Cell Lung (NSCLC) tumors as measured by CT and as assessed on gross pathology specimen. To compare the Tumor (T) stage based on size utilizing old and new International Association for the Study of Lung Cancer (IASLC) criteria.

47 patients diagnosed with Stage I or II NSCLC were evaluated after a neoadjuvant chemotherapy regimen. CT was performed using 1.25 mm slice thickness. Tumor contours were delineated using an automated segmentation algorithm and adjusted based on a radiologist’s input. Based on the tumor perimeter, maximal tumor linear diameter was calculated automatically. The largest diameter from the pathology gross report was utilized in the data analysis. A students’ T-test was used to evaluate for differences between the CT and pathologic linear diameter. The T stage was determined from the CT diameter and the pathologic specimen utilizing both the old and the new IASLC criteria.

The mean largest diameter of the tumors at CT and pathology was 29.53 mm and 24.04 mm, respectively (p < 0.031). Based upon CT diameter, 4 patients would be upstaged to T2a, T2b, T3 tumors using the new IASLC criteria compared with the older criteria. Based upon pathology diameter, 2 patients with T2b tumors would be staged differently using the new IASLC criteria compared with the older criteria. Patients with T1a and T1b tumors by CT or pathology received the same ultimate stage regardless of whether new or old size criteria were used.

There is a statistically significant difference between the tumor diameters as measured by CT and on pathology gross specimen. These differences result in upstaging of patients when applied to the new IASLC criteria and could have implications in the treatment and prognosis of patients with early stage NSCLC.

Differences between CT and pathology based measurements result in differences in T stage of early lung cancer, which could have implications on the ultimate stage of early lung cancer.

Lampen-Sachar, K, Zhao, B, Zakowski, M, Schwartz, L, Rizvi, N, Kris, M, Ginsberg, M, et al, 0, Is There a Correlation Between the T-Stage Measured by CT and Pathology for Solitary Primary Lung Tumors?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8008762.html