NGHIÊN CỨU ĐẶC ĐIỂM HÌNH ẢNH CẮT LỚP VI TÍNH ĐA DÃY ĐẦU THU NGỰC TRONG CHUẨN ĐOÁN UNG THƯ PHỔI NGUYÊN PHÁT Ở NGƯỜI LỚN

B GIO DC V O TO B QUC PHềNG VIN NGHIấN CU KHOA HC Y DC LM SNG 108 CUNG VN CễNG NGHIÊN CứU ĐặC ĐIểM HìNH ảNH CắT LớP VI TíNH ĐA DãY ĐầU THU NGựC TRONG CHẩN ĐOáN UNG THƯ PHổI NGUYÊN PHáT NGƯờI LớN LUN N TIN S Y HC H NI - 2015 B GIO DC V O TO B QUC PHềNG VIN NGHIấN CU KHOA HC Y DC LM SNG 108 CUNG VN CễNG NGHIÊN CứU ĐặC ĐIểM HìNH ảNH CắT LớP VI TíNH ĐA DãY ĐầU THU NGựC TRONG CHẩN ĐOáN UNG THƯ PHổI NGUYÊN PHáT NGƯờI LớN CHUYấN NGNH: CHN ON HèNH NH Mó s: 62.72.01.66 LUN N TIN S Y HC NGI HNG DN KHOA HC: GS.TS PHM MINH THễNG 2.TS INH VN CM H NI - 2015 LI CM N Tụi xin cam oan õy l cụng trỡnh nghiờn cu ca riờng tụi Cỏc s liu, kt qu nghiờn cu nờu lun ỏn l hon ton trung thc vafchuwa tng c cụng b bt k mt cụng trỡnh no khỏc Tỏc gi Cung Vn Cụng LI CM N Vi tt c lũng chõn thnh v bit n sõu sc, tụi xin trõn trng cm n: - Ban giỏm c, Phũng sau i hc Vin nghiờn cu khoa hc Y Dc lõm sng 108 - Ban giỏm c Bnh vin Phi trung ng - Khoa Chn oỏn hỡnh nh Bnh vin Phi trung ng ó cho phộp v to mi iu kin cho tụi c hc tp, nghiờn cu v hon thnh lun ỏn ny - GS.TS Phm Minh Thụng, TS inh Vn Cm Hai ngi Thy hng dn khoa hc ó rt tn tỡnh giỳp tụi hon thnh lun ỏn ny - Cỏc Thy B mụn Chn oỏn hỡnh nh Vin nghiờn cu khoa hc Y Dc lõm sng 108 ó to mi iu kin tt nht cho tụi quỏ trỡnh hc v úng gúp nhiu ý kin qỳi bỏu giỳp tụi hon thnh lun ỏn ny - TS.Nguyn Trng Giang, TS.ng c Nhu, BS.Nguyn Hong Thnh ó rt nhit tỡnh úng gúp ý kin, c kt qu ct lp vi tớnh v giỳp tụi x lý s liu ca lun ỏn ny - Xin by t lũng bit n n B, M, Anh, Em, V v cỏc Con ó tn ty, ng viờn, chm lo cho tụi sut thi gian hc - Xin chõn thnh cm n s giỳp , ng viờn ca ng nghip, bn bố thõn hu MC LC DANH MC CH VIT TT DANH MC HèNH DANH MC BNG DANH MC BIU T VN CHNG 1: TNG QUAN TI LIU.4 1.1 NGUYấN Lí CHP V CC CA S HèNH NH TRấN CT LP VI TNH LNG NGC.4 1.1.1 Nguyờn lý chp ct lp vi tớnh 1.1.1.1 Nguyờn lý chung 1.1.1.2 Nguyờn lý chp ct lp vi tớnh a dóy5 1.1.2 Cỏc ca s nh c bn ca ct lp vi tớnh ngc6 1.1.2.1 t ca s .6 1.1.2.2 Ca s nhu mụ phi 1.1.2.3 Ca s trung tht9 1.1.2.4 Ca s xng 10 1.2 NHC LI MT S VN V DCH T, LM SNG, Mễ BNH V IU TR UNG TH PHI .10 1.2.1 Dch t hc ung th phi 10 1.2.2 Du hiu lõm sng 11 1.2.3 Mụ bnh hc ung th phi 12 1.2.4 iu tr ung th phi 15 1.2.4.1 Phu thut 15 1.2.4.2 Húa cht 16 1.2.4.3 X tr 17 1.2.4.4 Quang ụng 17 1.2.4.5 t nhit cao tn .18 1.2.4.6 iu tr ớch .19 1.3 CC K THUT CHN ON HèNH NH S DNG TRONG UNG TH PHI .19 1.3.1 X Quang phi chun 19 1.3.2 Chp ct lp vi tớnh lng ngc 21 1.3.3 Chp cng hng t ngc 25 1.3.4 Chp ghi hỡnh phúng x PET v PET/CT 26 1.3.5 Siờu õm lng ngc 29 1.4 H THNG PHN LOI TNM TRONG UNG TH PHI V VAI TRề CA CHP CT LP VI TNH .29 1.4.1 H thng phõn loi TNM cho ung th 29 1.4.2 Phõn loi TNM cho ung th phi 30 1.4.3 Phõn loi giai on TNM cho ung th phi phiờn bn . 31 1.4.3.1 Phõn T 31 1.4.3.2 Phõn N 35 1.4.3.3 Phõn M 35 1.4.3.4 Cỏc thay i ch yu so sỏnh TNM6 v TNM7 35 1.4.3.5.nh hng ca cỏc thay i phõn loi TNM7 36 1.4.4 Vai trũ ca ct lp vi tớnh ỏnh giỏ giai on ung th phi 36 1.4.4.1 Kớch thc U 37 1.4.4.2 ỏnh giỏ mc xõm ln trung tht, thnh ngc, c honh 38 1.4.4.3 ỏnh giỏ di cn hch 39 1.5.TèNH HèNH NGHIấN CU TRONG V NGOI NC V VAI TRề CT LP VI TNH TRONG NG TH PHI 40 1.5.1 Tỡnh hỡnh nghiờn cu trờn th gii 40 1.5.2 Tỡnh hỡnh nghiờn cu ti Vit Nam 41 CHNG 2: I TNG V PHNG PHP NGHIấN CU 45 2.1 I TNG NGHIấN CU 45 2.1.1 Tiờu chun la chn 45 2.1.2 Tiờu chun loi tr 45 2.1.3 a im nghiờn cu 45 2.2 PHNG PHP NGHIấN CU 45 2.2.1 Thit k nghiờn cu 45 2.2.2 Chn mu nghiờn cu .45 2.3 NI DUNG V CC BIN S NGHIấN CU 45 2.3.1 Phng tin nghiờn cu .45 2.3.2 Cỏc bc tin hnh nghiờn cu 46 2.3.3 Cỏc bin s nghiờn cu ..48 2.3.3.1.U nguyờn phỏt, s lng, v trớ, kớch thc, th tch u nguyờn phỏt 48 2.3.3.2 c im hỡnh nh u nguyờn phỏt 49 2.3.3.3 c im xõm ln ca u nguyờn phỏt ..53 2.3.3.4 c im xp phi .55 2.3.3.5 c im hch trung tht 55 2.3.3.6 c im ca cỏc nt v tinh v cỏc tn thng khỏc 59 2.3.3.7 Phõn loi giai on tn thng 60 2.3.3.8 Thng kờ cỏc kt qu gii phu bnh 61 2.4 X Lí S LIU 66 2.4.1 Thu thp s liu 66 2.4.2 X lý s liu 66 2.5 O C NGHIấN CU .66 CHNG 3: KT QU NGHIấN CU 67 3.1 C IM CHUNG 67 3.1.1 Tui v gii .67 3.1.2 Cỏc type mụ bnh hc 68 3.1.3 Phõn b v trớ u nguyờn phỏt 69 3.2 C IM HèNH NH U NGUYấN PHT 72 3.2.1 c im ng b v mt ca u nguyờn phỏt .72 3.2.2 c im v kớch thc v th tớch u nguyờn phỏt 74 3.2.3 c im ngm thuc cn quang ca u nguyờn phỏt 76 3.2.4 Cỏc du hiu hỡnh nh khỏc trờn phim ct lp vi tớnh .79 3.2.5 c im xp phi kt hp 82 3.2.6 c im xõm ln trung tht, thnh ngc 85 3.3 C IM HèNH NH HCH TRUNG THT 87 3.3.1 c im hỡnh nh hch ln trung tht cú kh nng l hch th phỏt.87 3.3.2 c im s lng, kớch thc hch ln trung tht cú kh nng l hch th phỏt 89 3.3.3 Giỏ tr chn oỏn hch trung tht th phỏt trờn ct lp vi tớnh 92 3.4 C IM HèNH NH CC TN THNG TH PHT .92 3.5 PHN LOI GIAI ON UNG TH PHI TRấN CT LP VI TNH NGC 94 3.5.1 Phõn T 94 3.5.2 Phõn N 95 3.5.3 Phõn M 96 3.5.4 Giai on chung 97 CHNG 4: BN LUN 99 4.1.C IM CHUNG.99 4.1.1 Tui 99 4.1.2 Gii. 100 4.1.3 Cỏc type mụ bnh hc .100 4.2 C IM HèNH NH U NGUYấN PHT .102 4.2.1 ng kớnh ln nht u 102 4.2.2 Th tớch u 103 4.2.3 V trớ u 105 4.2.4 c im ng b u 107 4.2.5 c im v mt u 108 4.2.6 c im ngm thuc ca u 111 4.2.7 Cỏc du hiu khỏc phi hp 113 4.2.7.1 Cỏc du hiu ph qun .113 4.2.7.2 Cỏc du hiu mng phi 113 4.2.7.3 Xp phi 114 4.2.7.4 Di cn bch mch 117 4.2.7.5 Cỏc du hiu xõm ln 117 4.3 C IM HèNH NH HCH TRUNG THT 118 4.3.1 Hỡnh thỏi v kớch thc hch 118 4.3.2 Phõn b v trớ nhúm hch 120 4.4 C IM TN THNG TH PHT 121 4.5 CHN ON GIAI ON UNG TH PHI TNM 123 4.5.1 Phõn T .123 4.5.2 Phõn N .124 4.5.3 Phõn M 126 4.5.4 Thay i giai on u phi gia TNM v TNM .127 4.6 SO SNH C IM HèNH NH CT LP VI TNH GIA UNG TH PHI TYPE BIU Mễ VY V BIU Mễ TUYN127 4.6.1 c im v hỡnh nh 127 4.6.1.1 V trớ u 127 4.6.1.2 ng b v mc ngm thuc cn quang 129 4.6.2 c im hch th phỏt kt hp ..129 4.6.3 Khỏc bit v giai on TNM trờn ct lp vi tớnh ngc 130 KT LUN 131 KIN NGH CC CễNG TRèNH NGHIấN CU CễNG B Cể LIấN QUAN N LUN N TI LIU THAM KHO MU BNH N NGHIấN CU DANH SCH BNH NHN NGHIấN CU DANH MC CH VIT TT Phn vit tt Phn vit y BN CLVT Bnh nhõn Ct lp vi tớnh CHT GPB Cng hng t Gii phu bnh STXTN UTP Sinh thit xuyờn thnh ngc Ung th phi XQ CS DSA HU X quang Cng s Digital Subtraction Angiography Chp mch xúa nn s húa Hounsfield Unit n v o t trng MPR MSCT MIP T N M Multiplanar Reconstruction - Tỏi to hỡnh a hng Multislice Computed Tomography chp ct lp vi tớnh a dóy Maximum Idensity Projection K thut hỡnh chiu cng ti a Tumor Khi u Node - Hch Metastasis Di cn PET / CT Positron Emission Tomography / Computed Tomography Chp ct lp phỏt x Positron / chp ct lp vi tớnh VRT AJCC Volume Rendering Technique K thut hin th b mt th tớch IUCC VALSG WHO RECIST American Joint Committee on Cancer y ban hn hp nghiờn cu ung th Hoa k International Union Contre le Cancer - Hip hi phũng chng ung th quc t Veterans Administration Lung Study Group Nhúm i din ca cỏc chuyờn gia nghiờn cu v phi World Health Organization T chc y t th gii Response Evaluation Criteria in Solid Tumor Tiờu ỏnh giỏ ỏp ng u c TI LIU THAM KHO TING VIT Lờ Tun Anh v Nguyn Ngc Bo Hong (2013), "c im lõm sng v iu tr ca 1158 bnh nhõn ung th phi ti trung tõm ung bu Ch Ry", Y hc thc hnh 878(8/2013), pp 20-22 Phựng Th Phng Anh (1999), "Typ mụ bnh hc ca ung th phi qua nm 1995-1998 nhng bnh nhõn ó phu thut", Lun thc s y hc i hc y H Ni, H Ni Ngụ Quý Chõu (1992), "Gúp phn nghiờn cu giỏ tr chn oỏn ung th phi ca sinh thit hỳt kim nh qua thnh ngc", Lun phú tin s khoa hc Y dc Ngụ Quý Chõu (2011), "Ung th phi tiờn phỏt", Bnh hụ hp, Nh xut bn giỏo dc Vit Nam, pp 223-268 Nguyn Vit C v Tụ Kiu Dung (1994), "Ung th ph qun phi qua 579 trng hp phu thut", Ni san Lao v Bnh phi 15, pp 28-29 Chung Giang ụng v Kim Qu (2008), "Giỏ tr ca CT scan chn oỏn di cn hch ca ung th phi nguyờn phỏt", Y hc Vit Nam 11(2), pp 505-515 Lờ Tin Dng (2000), "Ung th ph qun: Mt s c im lõm sng v vai trũ chp ct lp in toỏn chn oỏn", Luõn ỏn tin s y hc Trng i hc Y dc Thnh ph H Chớ Minh Tụ Th Kiu Dung (1995), "i chiu lõm sng, Xquang phi vi cỏc typ mụ bnh hc v giai on bnh ca ung th phi nguyờn phỏt nhng bnh nhõn ó phu thut", Lun ỏn phú tin s y hc Hc vin quõn y Nguyn Minh Hi v Nguyn ỡnh Tin (2013), "Nghiờn cu c im X quang phi 325 bnh nhõn ung th phi khụng t bo nh", Tp Y dc lõm sng 108 8(05/2013), pp 74-79 10 Hong Th Hip (1999), "c im lõm sng Xquang phi, typ mụ bnh v siờu cu trỳc ca ung th phi", Lun ỏn thc s y hc Hc vin Quõn y, H Ni 11 ng c Hng (2014), "Nghiờn cu phng phỏp sinh thit xuyờn thnh ngc chn oỏn tn thng phi", Lun ỏn tin s Y hc Trng i hc Y dc Thnh ph H Chớ Minh 12 ng Khc Hng (1995), "Nghiờn cu v lõm sng, XQ phi chun v mt s k thut xõm nhp chn oỏn ung th phi nguyờn phỏt", Lun ỏn phú tin s y hc 13 Nguyn ỡnh Hng (2011), " Chc sinh thit xuyờn thnh ngc cỏc u phi di hng dn ca ct lp vi tớnh a dóy: nhn xột qua 280 trng hp ti bnh vin Ung bu H Ni", Y hc thc hnh 773(7), pp 41-43 14 Mai Trng Khoa (2010), "Vai trũ ca PET/CT ung th phi khụng t bo nh", Tp in quang Vit Nam 1, pp 32-39 15 on Th Phng Lan (2015), "Nghiờn cu c im hỡnh nh v giỏ tr ca sinh thit xuyờn thnh ngc di hng dn ca chp ct lp vi tớnh chn oỏn cỏc tn thng dng u phi", Lun ỏn tin s Y hc, trng i hc Y h Ni 16 Nguyn Hoi Nam (2003), "Nghiờn cu hỡnh thỏi gii phu bnh v lõm sng ca ung th phi c iu tr bng phu thut", Y hc thnh ph H Chớ Minh 7(Ph bn ca S nm 2003), pp 66-73 17 Trn Nguyờn Phỳ (2005), "Nghiờn cu lõm sng v phõn loi T.N.M ung th ph qun khụng t bo nh", Lun tt nghip bỏc s chuyờn khoa cp II Trng i hc Y H Ni 18 Bựi Xuõn Tỏm (1996), "Tng kt nghiờn cu lõm sng, Xquang phi chun v cỏc k thut xõm nhp chn oỏn mụ bnh - t bo bnh nhõn ung th ph qun nguyờn phỏt p dng khoa hc k thut phũng chng ung th phi Vit Nam", Tng hi y dc hc Vit Nam Hi lao v bnh phi - Vin lao v bnh phi, pp 43-80 19 Trn Vn Thun (2014), "Nhn xột c im hỡnh nh ni soi ca bnh nhõn ung th ph qun phi", Y hc thc hnh 914 (S 4/2014), pp 82-85 TING ANH 20 Aglietta, M and Regge, D (2012), "Imaging tumor response to therapy", Springer - Verlag, Italia, pp 109-123 21 American Lung Association (2014), "Trends in lung cancer morbidity and mortality" 22 Antoch, G., et al (2003), "Non-small cell lung cancer: dual-modality PET/CT in preoperative staging", Radiology 229(2), pp 526-33 23 Antoch, G., et al (2003), "Whole-body dual-modality PET/CT and whole-body MRI for tumor staging in oncology", JAMA 290(24), pp 3199-206 24 Aoki, T., et al (2000), "Evolution of peripheral lung adenocarcinomas: CT findings correlated with histology and tumor doubling time", AJR Am J Roentgenol 174(3), pp 763-8 25 Ashamalla, H., et al (2005), "The contribution of integrated PET/CT to the evolving definition of treatment volumes in radiation treatment planning in lung cancer", Int J Radiat Oncol Biol Phys 63(4), pp 1016-23 26 Austin, J H., Romney, B M., and Goldsmith, L S (1992), "Missed bronchogenic carcinoma: radiographic findings in 27 patients with a potentially resectable lesion evident in retrospect", Radiology 182(1), pp 115-22 27 Bandi, V., et al (2008), "Ultrasound vs CT in detecting chest wall invasion by tumor: a prospective study", Chest 133(4), pp 881-6 28 Berland, L L and Smith, J K (1998), "Multidetector-array CT: once again, technology creates new opportunities", Radiology 209(2), pp 327-9 29 Birim, O., et al (2005), "Meta-analysis of positron emission tomographic and computed tomographic imaging in detecting mediastinal lymph node metastases in nonsmall cell lung cancer", Ann Thorac Surg 79(1), pp 375-82 30 Bruzzi, J F and Munden, R F (2006), "PET/CT imaging of lung cancer", J Thorac Imaging 21(2), pp 123-36 31 Bungay, H K., et al (2000), "An evaluation of computed tomography as an aid to diagnosis in patients undergoing bronchoscopy for suspected bronchial carcinoma", Clin Radiol 55(7), pp 554-60 32 Cerfolio, R J and Bryant, A S (2006), "Distribution and likelihood of lymph node metastasis based on the lobar location of nonsmall-cell lung cancer", Ann Thorac Surg 81(6), pp 1969-73 33 Chaudhuri, M R (1973), "Primary pulmonary cavitating carcinomas", Thorax 28(3), pp 354-66 34 Chheang, S and Brown, K (2013), "Lung cancer staging: clinical and radiologic perspectives", Semin Intervent Radiol 30(2), pp 99-113 35 Chooi, W K., et al (2003), "Multislice helical CT: the value of multiplanar image reconstruction in assessment of the bronchi and small airways disease", Br J Radiol 76(908), pp 536-40 36 Dehing-Oberije, C., et al (2008), "Tumor volume combined with number of positive lymph node stations is a more important prognostic factor than TNM stage for survival of non-small-cell lung cancer patients treated with (chemo)radiotherapy", Int J Radiat Oncol Biol Phys 70(4), pp 1039-44 37 Deppen, S., et al (2011), "Accuracy of FDG-PET to diagnose lung cancer in a region of endemic granulomatous disease", Ann Thorac Surg 92(2), pp 428-32 38 Detterbeck, F C., et al (2010), "Details and difficulties regarding the new lung cancer staging system", Chest 137(5), pp 1172-80 39 Detterbeck, F C., Postmus, P E., and Tanoue, L T (2013), "The stage classification of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines", Chest 143(5 Suppl), pp e191S-210S 40 Doll, R and Hill, A B (1964), "Mortality in Relation to Smoking: Ten Years' Observations of British Doctors", Br Med J 1(5396), pp 14607 41 Douillard, J Y., et al (2010), "Adjuvant cisplatin and vinorelbine for completely resected non-small cell lung cancer: subgroup analysis of the Lung Adjuvant Cisplatin Evaluation", J Thorac Oncol 5(2), pp 220-8 42 Dung To Kieu, Co Nguyen Viet, Anh Phung Phuong (2001), "Surgery for lung cancer at the National Institute for tuberculosis and respiratory diseases, Hanoi, Vietnam", The 21th IUATLD Eastern Region Conference and the 20th PCCP Annual convention, Manila, Philippines, March 2001, pp 40 43 El-Sherief, A H., et al (2014), "International association for the study of lung cancer (IASLC) lymph node map: radiologic review with CT illustration", Radiographics 34(6), pp 1680-91 44 Ferlay, J., et al (2010), "Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008", Int J Cancer 127(12), pp 2893-917 45 Ferlay, J., et al (2015), "Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012", Int J Cancer 136(5), pp E359-86 46 Funai, K., et al (2003), "Clinicopathologic characteristics of peripheral squamous cell carcinoma of the lung", Am J Surg Pathol 27(7), pp 978-84 47 Furuya, K., et al (1999), "New classification of small pulmonary nodules by margin characteristics on high-resolution CT", Acta Radiol 40(5), pp 496-504 48 Gaeta, M., et al (1999), "Radiolucencies and cavitation in bronchioloalveolar carcinoma: CT-pathologic correlation", Eur Radiol 9(1), pp 55-9 49 Gavrielides, M A., et al (2009), "Noncalcified lung nodules: volumetric assessment with thoracic CT", Radiology 251(1), pp 2637 50 Gdeedo, A., et al (1997), "Prospective evaluation of computed tomography and mediastinoscopy in mediastinal lymph node staging", Eur Respir J 10(7), pp 1547-51 51 Glazer, G M., et al (1985), "Normal mediastinal lymph nodes: number and size according to American Thoracic Society mapping", AJR Am J Roentgenol 144(2), pp 261-5 52 Glazer, H S., et al (1985), "Pleural and chest wall invasion in bronchogenic carcinoma: CT evaluation", Radiology 157(1), pp 1914 53 Glazer, H S., et al (1989), "Indeterminate mediastinal invasion in bronchogenic carcinoma: CT evaluation", Radiology 173(1), pp 3742 54 Goldstraw, P., et al (2007), "The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours", J Thorac Oncol 2(8), pp 706-14 55 Golfieri, R., et al (1991), "Comparative evaluation of computerized tomography/magnetic resonance (1.5 T) in the detection of brain metastasis", Radiol Med 82(1-2), pp 27-34 56 Grgic, A., et al (2009), "Nonrigid versus rigid registration of thoracic 18F-FDG PET and CT in patients with lung cancer: an intraindividual comparison of different breathing maneuvers", J Nucl Med 50(12), pp 1921-6 57 Gurney, J W (1993), "Determining the likelihood of malignancy in solitary pulmonary nodules with Bayesian analysis Part I Theory", Radiology 186(2), pp 405-13 58 Heitzman, E R., et al (1982), "Pathways of tumor spread through the lung: radiologic correlations with anatomy and pathology", Radiology 144(1), pp 3-14 59 Hellwig, D., Baum, R P., and Kirsch, C (2009), "FDG-PET, PET/CT and conventional nuclear medicine procedures in the evaluation of lung cancer: a systematic review", Nuklearmedizin 48(2), pp 59-69 60 Henschke, C I., et al (2002), "CT screening for lung cancer: frequency and significance of part-solid and nonsolid nodules", AJR Am J Roentgenol 178(5), pp 1053-7 61 Ichinose, Y., et al (1989), "Preoperative examination to detect distant metastasis is not advocated for asymptomatic patients with stages and non-small cell lung cancer Preoperative examination for lung cancer", Chest 96(5), pp 1104-9 62 Jemal, A., et al (2008), "Annual report to the nation on the status of cancer, 1975-2005, featuring trends in lung cancer, tobacco use, and tobacco control", J Natl Cancer Inst 100(23), pp 1672-94 63 Kakinuma, R., et al (2004), "Progression of focal pure ground-glass opacity detected by low-dose helical computed tomography screening for lung cancer", J Comput Assist Tomogr 28(1), pp 17-23 64 Kaplan, D and Goldstraw, P (1995), "New techniques in the diagnosis and staging of lung cancer", Cancer Treat Res 72, pp 223-54 65 Kawamura, M., et al (2006), "Percutaneous cryoablation of small pulmonary malignant tumors under computed tomographic guidance with local anesthesia for nonsurgical candidates", J Thorac Cardiovasc Surg 131(5), pp 1007-13 66 Kiessling, F., et al (2004), "Perfusion CT in patients with advanced bronchial carcinomas: a novel chance for characterization and treatment monitoring?", Eur Radiol 14(7), pp 1226-33 67 Kim, H Y., et al (2007), "Persistent pulmonary nodular ground-glass opacity at thin-section CT: histopathologic comparisons", Radiology 245(1), pp 267-75 68 Kim, H Y., et al (2008), "Nodal metastasis in non-small cell lung cancer: accuracy of 3.0-T MR imaging", Radiology 246(2), pp 596604 69 Kim, S K., et al (2007), "Accuracy of PET/CT in characterization of solitary pulmonary lesions", J Nucl Med 48(2), pp 214-20 70 Kiyono, K., et al (1988), "The number and size of normal mediastinal lymph nodes: a postmortem study", AJR Am J Roentgenol 150(4), pp 771-6 71 Kotoulas, C S., et al (2004), "Involvement of lymphatic metastatic spread in non-small cell lung cancer accordingly to the primary cancer location", Lung Cancer 44(2), pp 183-91 72 Lai, R S., Perng, R P., and Chang, S C (1992), "Primary lung cancer complicated with pneumothorax", Jpn J Clin Oncol 22(3), pp 194-7 73 Lampen-Sachar, K., et al (2012), "Correlation between tumor measurement on Computed Tomography and resected specimen size in lung adenocarcinomas", Lung Cancer 75(3), pp 332-5 74 Lederlin, M., et al (2013), "Correlation of radio- and histomorphological pattern of pulmonary adenocarcinoma", Eur Respir J 41(4), pp 943-51 75 Lee, H Y and Lee, K S (2011), "Ground-glass opacity nodules: histopathology, imaging evaluation, and clinical implications", J Thorac Imaging 26(2), pp 106-18 76 Lee, K S., et al (1997), "Evaluation of tracheobronchial disease with helical CT with multiplanar and three-dimensional reconstruction: correlation with bronchoscopy", Radiographics 17(3), pp 555-67; discussion 568-70 77 Lee, W K., et al (2013), "Modern diagnostic and therapeutic interventional radiology in lung cancer", J Thorac Dis Suppl 5, pp S511-23 78 Li, Y., Chen, K Z., and Wang, J (2011), "Development and validation of a clinical prediction model to estimate the probability of malignancy in solitary pulmonary nodules in Chinese people", Clinic Lung Cancer 12(5), pp 313-9 79 Lin, C., et al (2007), "Whole body MRI and PET/CT in haematological malignancies", Cancer Imaging Spec No A, pp S88-93 80 Little, A G., et al (2005), "Patterns of surgical care of lung cancer patients", Ann Thorac Surg 80(6), pp 2051-6 81 McLoud, T C., et al (1992), "Bronchogenic carcinoma: analysis of staging in the mediastinum with CT by correlative lymph node mapping and sampling", Radiology 182(2), pp 319-23 82 Montesinos, J., et al (2011), "The changing pattern of non-small cell lung cancer between the 90 and 2000 decades", Open Respir Med J 5, pp 24-30 83 Mountain, C F (1997), "Revisions in the International System for Staging Lung Cancer", Chest 111(6), pp 1710-7 84 Munk, P L., et al (1988), "Pulmonary lymphangitic carcinomatosis: CT and pathologic findings", Radiology 166(3), pp 705-9 85 Naidich, D P., et al (2013), "Recommendations for the management of subsolid pulmonary nodules detected at CT: a statement from the Fleischner Society", Radiology 266(1), pp 304-17 86 Naidich, D P., et al (1983), "Computed tomography of lobar collapse: Endobronchial obstruction", J Comput Assist Tomogr 7(5), pp 74557 87 Naidich, D P., et al (1983), "Computed tomography of lobar collapse: Collapse in the absence of endobronchial obstruction", J Comput Assist Tomogr 7(5), pp 758-67 88 National Comprehensive Cancer Network (2015), "NCCN clinical practice guidelines in oncology Non-small cell lung cancer" 89 Nestor L Muller and C Isabela S Silva (2008), "Imaging of the chest " 90 Nishino, M., et al (2014), "State of the art: Response assessment in lung cancer in the era of genomic medicine", Radiology 271(1), pp 627 91 Nishino, M., et al (2014), "Revisiting the relationship between tumour volume and diameter in advanced NSCLC patients: An exercise to maximize the utility of each measure to assess response to therapy", Clin Radiol 69(8), pp 841-8 92 Oh, J Y., et al (2007), "Clinical significance of a solitary ground-glass opacity (GGO) lesion of the lung detected by chest CT", Lung Cancer 55(1), pp 67-73 93 Onitsuka, H., et al (1991), "Differentiation of central lung tumor from postobstructive lobar collapse by rapid sequence computed tomography", J Thorac Imaging 6(2), pp 28-31 94 Pignon, J P., et al (2008), "Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE Collaborative Group", J Clin Oncol 26(21), pp 3552-9 95 Pirronti, T., et al (2000), "[Evaluation of the "N" factor in nonsmall cell lung cancer Correlation between computerized tomography and pathologic anatomy]", Radiol Med 99(5), pp 340-6 96 Prabhakar, H B., et al (2008), "Imaging features of sarcoidosis on MDCT, FDG PET, and PET/CT", AJR Am J Roentgenol 190(3 Suppl), pp S1-6 97 Prenzel, K L., et al (2003), "Lymph node size and metastatic infiltration in non-small cell lung cancer", Chest 123(2), pp 463-7 98 Quint, L E and Francis, I R (1999), "Radiologic staging of lung cancer", J Thorac Imaging 14(4), pp 235-46 99 Rami-Porta, R., Crowley, J J., and Goldstraw, P (2009), "The revised TNM staging system for lung cancer", Ann Thorac Cardiovasc Surg 15(1), pp 4-9 100 Ratto, G B., et al (1991), "Chest wall involvement by lung cancer: computed tomographic detection and results of operation", Ann Thorac Surg 51(2), pp 182-8 101 Revel, M P., et al (2006), "Software volumetric evaluation of doubling times for differentiating benign versus malignant pulmonary nodules", AJR Am J Roentgenol 187(1), pp 135-42 102 Ridge, C A., et al (2013), "Comparison of multiplanar reformatted CT lung tumor measurements to axial tumor measurement alone: impact on maximal tumor dimension and T stage", AJR Am J Roentgenol 201(5), pp 959-63 103 Ridge, C A., McErlean, A M., and Ginsberg, M S (2013), "Epidemiology of lung cancer", Semin Intervent Radiol 30(2), pp 938 104 Rusch, V W., et al (2009), "The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer", J Thorac Oncol 4(5), pp 568-77 105 Sanli, M., et al (2009), "Reliability of positron emission tomographycomputed tomography in identification of mediastinal lymph node status in patients with non-small cell lung cancer", J Thorac Cardiovasc Surg 138(5), pp 1200-5 106 Schultz, E M., et al (2008), "Validation of two models to estimate the probability of malignancy in patients with solitary pulmonary nodules", Thorax 63(4), pp 335-41 107 Shah, P K., et al (2003), "Missed non-small cell lung cancer: radiographic findings of potentially resectable lesions evident only in retrospect", Radiology 226(1), pp 235-41 108 Shepherd, F A., et al (2007), "The International Association for the Study of Lung Cancer lung cancer staging project: proposals regarding the clinical staging of small cell lung cancer in the forthcoming (seventh) edition of the tumor, node, metastasis classification for lung cancer", J Thorac Oncol 2(12), pp 1067-77 109 Sider, L (1990), "Radiographic manifestations of primary bronchogenic carcinoma", Radiol Clin North Am 28(3), pp 583-97 110 Siegelman, S S., et al (1980), "CT of the solitary pulmonary nodule", AJR Am J Roentgenol 135(1), pp 1-13 111 Silvestri, G A., et al (2013), "Methods for staging non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines", Chest 143(5 Suppl), pp e211S-50S 112 Silvestri, G A., et al (2007), "Noninvasive staging of non-small cell lung cancer: ACCP evidenced-based clinical practice guidelines (2nd edition)", Chest 132(3 Suppl), pp 178S-201S 113 Silvestri, G A., Littenberg, B., and Colice, G L (1995), "The clinical evaluation for detecting metastatic lung cancer A meta-analysis", Am J Respir Crit Care Med 152(1), pp 225-30 114 Simon, C J., et al (2007), "Pulmonary radiofrequency ablation: longterm safety and efficacy in 153 patients", Radiology 243(1), pp 26875 115 Sioris, T., et al (2003), "Comparison of computed tomography and systematic lymph node dissection in determining TNM and stage in non-small cell lung cancer", Eur J Cardiothorac Surg 23(3), pp 403-8 116 Sobin I, Gospodarowicz M, and C, Wittekind (2010), "TNM classification of malignant tumours 7th edition", Blackwell Publishing, Oxford, UK 117 Soubani, A O (2008), "The evaluation and management of the solitary pulmonary nodule", Postgrad Med J 84(995), pp 459-66 118 Sripathi, S and Mahajan, A (2013), "Comparative study evaluating the role of color Doppler sonography and computed tomography in predicting chest wall invasion by lung tumors", J Ultrasound Med 32(9), pp 1539-46 119 Steinhauslin, C A and Cuttat, J F (1985), "Spontaneous pneumothorax A complication of lung cancer?", Chest 88(5), pp 70913 120 Stellman, S D., et al (1997), "Risk of squamous cell carcinoma and adenocarcinoma of the lung in relation to lifetime filter cigarette smoking", Cancer 80(3), pp 382-8 121 Sugiura, S., et al (1997), "Prognostic value of pleural effusion in patients with non-small cell lung cancer", Clin Cancer Res 3(1), pp 47-50 122 Swensen, S J., et al (1997), "The probability of malignancy in solitary pulmonary nodules Application to small radiologically indeterminate nodules", Arch Intern Med 157(8), pp 849-55 123 Swensen, S J., et al (2000), "Lung nodule enhancement at CT: multicenter study", Radiology 214(1), pp 73-80 124 Tahiri, M., et al (2014), "Preoperative assessment of chest wall invasion in non-small cell lung cancer using surgeon-performed ultrasound", Ann Thorac Surg 98(3), pp 984-9 125 Takashima, S., et al (2003), "Indeterminate solitary pulmonary nodules revealed at population-based CT screening of the lung: using first follow-up diagnostic CT to differentiate benign and malignant lesions", AJR Am J Roentgenol 180(5), pp 1255-63 126 Teh, Elaine and Belcher, Elizabeth (2014), "Lung cancer: Diagnosis, staging and treatment", Cardiothoracic surgery Elsevier, pp 242-248 127 Theros, E G (1977), "1976 Caldwell Lecture: varying manifestation of peripheral pulmonary neoplasms: a radiologic-pathologic correlative study", AJR Am J Roentgenol 128(6), pp 893-914 128 Tobler, J., et al (1987), "Differentiation of proximal bronchogenic carcinoma from postobstructive lobar collapse by magnetic resonance imaging Comparison with computed tomography", Invest Radiol 22(7), pp 538-43 129 Toloza, E M., Harpole, L., and McCrory, D C (2003), "Noninvasive staging of non-small cell lung cancer: a review of the current evidence", Chest 123(1 Suppl), pp 137S-146S 130 Traill, Z C and Gleeson, F V (2003), "Bronchoscopy and surgical staging procedures and their correlation with imaging", Eur J Radiol 45(1), pp 39-48 131 Travis, W D , et al (2014), "WHO classification of tumours of the Lung, Pleura, Thymus and Heart IARC Press." 132 Tsukamoto, T., et al (1995), "[Primary lung cancer presenting as spontaneous pneumothorax]", Nihon Kyobu Shikkan Gakkai Zasshi 33(9), pp 936-9 133 Uffmann, M and Prokop, M (2001), "[Multislice CT of the lung Technique and clinical applications]", Radiologe 41(3), pp 240-7 134 W Richard Webb and Charles B Higgins (2011), "Thoracic imaging Caridovascular radiology, 2nd ed." 135 Webb, W R., et al (1991), "CT and MR imaging in staging non-small cell bronchogenic carcinoma: report of the Radiologic Diagnostic Oncology Group", Radiology 178(3), pp 705-13 136 Winer-Muram, H T (2006), "The solitary pulmonary nodule", Radiology 239(1), pp 34-49 137 Wisnivesky, J P., Yankelevitz, D., and Henschke, C I (2005), "Stage of lung cancer in relation to its size: part Evidence", Chest 127(4), pp 1136-9 138 Woodring, J H and Fried, A M (1983), "Significance of wall thickness in solitary cavities of the lung: a follow-up study", AJR Am J Roentgenol 140(3), pp 473-4 139 Woodring, J H., Fried, A M., and Chuang, V P (1980), "Solitary cavities of the lung: diagnostic implications of cavity wall thickness", AJR Am J Roentgenol 135(6), pp 1269-71 140 Woodring, J H and Stelling, C B (1983), "Adenocarcinoma of the lung: a tumor with a changing pleomorphic character", AJR Am J Roentgenol 140(4), pp 657-64 141 Yankelevitz, D., Wisnivesky, J P., and Henschke, C I (2005), "Stage of lung cancer in relation to its size: part Insights", Chest 127(4), pp 1132-5 142 Zemlyak, A., Moore, W H., and Bilfinger, T V (2010), "Comparison of survival after sublobar resections and ablative therapies for stage I non-small cell lung cancer", J Am Coll Surg 211(1), pp 68-72 143 Zerhouni, E A., et al (1986), "CT of the pulmonary nodule: a cooperative study", Radiology 160(2), pp 319-27 144 Zhao, B., et al (2010), "A pilot study of volume measurement as a method of tumor response evaluation to aid biomarker development", Clin Cancer Res 16(18), pp 4647-53 145 Zhao, B., et al (2006), "Lung cancer: computerized quantification of tumor response initial results", Radiology 241(3), pp 892-8 146 Zwirewich, C V., et al (1991), "Solitary pulmonary nodule: highresolution CT and radiologic-pathologic correlation", Radiology 179(2), pp 469-76