| Comparison of pulmonary nodule detection rates between preoperative CT imaging and intraoperative lung palpation. | |
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MedLine Citation:
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PMID: 21545910 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Recent advances in computed tomographic (CT) imaging have improved the detection rate of pulmonary metastasis. The aim of this study was to test the hypothesis that the pulmonary nodule detection rate for preoperative CT imaging and intraoperative palpation are now equivalent. METHODS: A retrospective review of 108 pulmonary metastasectomies in 84 patients was performed. The number of nodules detected on preoperative CT imaging by radiologist report was compared with the number of malignant nodules identified on pathology. Secondary outcome measures were operative approach and primary malignancy. RESULTS: Sarcoma metastases were the most common indication for resection (n = 54 [50%]). Thirty-three percent of metastasectomies were performed using a thoracoscopic approach. When thoracotomy was used, significantly more nodules were palpated and resected than were identified on preoperative CT imaging (3.24 vs 2.12, P < .001). Significantly more of these nodules were confirmed malignant on final pathology (2.40 vs 1.60, P = .01). This difference was not seen for thoracoscopic resections. CONCLUSIONS: Although the sensitivity of CT imaging has improved, a significant number of malignant pulmonary nodules are detected intraoperatively that are not identified on preoperative imaging. Patients undergoing pulmonary metastasectomy require careful intraoperative palpation of lung parenchyma, and therefore open thoracotomy remains the standard of care. |
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Authors:
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Michelle C Ellis; Crystal J Hessman; Roshanthi Weerasinghe; Paul H Schipper; John T Vetto |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: American journal of surgery Volume: 201 ISSN: 1879-1883 ISO Abbreviation: Am. J. Surg. Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-05-06 Completed Date: 2011-07-19 Revised Date: 2011-08-25 |
Medline Journal Info:
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Nlm Unique ID: 0370473 Medline TA: Am J Surg Country: United States |
Other Details:
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Languages: eng Pagination: 619-22 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Surgical Oncology and Division of Cardiothoracic Surgery, Oregon Health and Science University, Portland, OR, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Diagnosis, Differential Humans Intraoperative Period Lung Neoplasms / diagnosis*, secondary Neoplasm Metastasis / diagnosis Palpation / methods* Reproducibility of Results Retrospective Studies Solitary Pulmonary Nodule / diagnosis*, secondary Thoracotomy* Tomography, X-Ray Computed* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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