KUMJ | VOL. 22 | NO. 4 | ISSUE 88 | OCTOBER. - DECEMBER. 2024
Comparison of Ultrasonography with Computed Tomography in Diagnosis and Staging of Lung Cancer
Paudel S, Kayastha P, Suwal S, Nepal B, Bhusal KR, Katwal S, Regmi PR
Abstract: Background
Ultrasound (US) can aid in lung cancer diagnosis and staging in peripheral-based
lesions by demonstrating chest wall invasion, aiding as a guide to biopsy, and detecting
supraclavicular lymph nodes which are often missed by computed tomography (CT).
Objective
This study is to compare the ultrasound with computed tomography in the diagnosis
and staging of lung cancer.
Method
This was an observational prospective study conducted from October 2020 to April
2023 in patients with or suspected lung cancer sent for imaging assessment to the
Department of Radiology and Imaging. Out of 306 patients who underwent computed
tomography scan, a total of 234 patients with proven lung cancer were subjected
to ultrasound of the chest, liver, bilateral adrenal, and supraclavicular regions for
the evaluation of lung mass, pleural effusion, and metastasis in lung, adrenal, and
supraclavicular lymph nodes. Diagnostic values of ultrasound to detect peripheral
lung lesions, chest wall invasion, pleural effusion, liver and adrenal metastasis, and
supraclavicular lymph nodes were compared with contrast-enhanced computed
tomography scans. Ultrasound’s performance was evaluated against computed
tomography scans as the gold standard, using the chi-square test, z-test, and area
under the curve for comparison (p < 0.05 for significance).
Result
The majority of patients (53.8%, n=126) were aged 61-75, with 53% being male
and 89% smokers. Ultrasound was superior in detecting pleural effusion (sensitivity
80.3%, NPV 92.2%, AUC 0.860) and supraclavicular lymph nodes (sensitivity 72.2%,
NPV 91.6%, AUC 0.817).
Conclusion
In resource-constrained settings like Nepal, where advanced imaging may be limited,
integrating ultrasound with contrast-enhanced computed tomography significantly
improves lung cancer diagnosis. This non-radiation approach is particularly beneficial
for peripheral lesions, patients with renal function impairment and aiding effective
staging of lung cancer.
Keyword : Computed tomography, Lung cancer, Role, Ultrasound
