When to perform preoperative chest computed tomography for renal cancer staging

2016 ◽  
Vol 120 (4) ◽  
pp. 490-496 ◽  
Author(s):  
Alessandro Larcher ◽  
Paolo Dell'Oglio ◽  
Nicola Fossati ◽  
Alessandro Nini ◽  
Fabio Muttin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Renal Cancer ◽  
Cancer Staging ◽  
Chest Computed Tomography ◽  
Preoperative Chest

scholarly journals Efficacy of chest computed tomography prediction of the pathological TNM stage of thymic epithelial tumours†

2019 ◽  
Vol 56 (2) ◽  
pp. 285-293 ◽  
Author(s):  
Darin B White ◽  
Megan J Hora ◽  
Sarah M Jenkins ◽  
Randolph S Marks ◽  
Yolanda I Garces ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Neoadjuvant Therapy ◽  
Tnm Staging ◽  
Chest Ct ◽  
Tnm Stage ◽  
Kappa Statistics ◽  
Chest Computed Tomography ◽  
Staging Systems ◽  
Epithelial Tumours ◽  
Preoperative Chest

Abstract OBJECTIVES The aim of this study is to evaluate the efficacy of chest computed tomography (CT) to predict the pathological stage of thymic epithelial tumours (TET) using the recently introduced tumour, node and metastasis (TNM) staging with comparison to the modified Masaoka staging. METHODS Preoperative chest CT examinations in cases of resected TET with sampled lymph nodes (2006–2016) were retrospectively reviewed by 2 thoracic radiologists and radiologically (r) staged using both staging systems. A thoracic pathologist reviewed all cases for the pathological (p) stage. Concordance between r-staging and p-staging was assessed by % agreement and unweighted kappa statistics. Associations between r-stage and p-stage with outcomes were assessed using the Cox proportional hazards regression. RESULTS Sixty patients with TET were included (47 thymomas, 12 thymic carcinomas and 1 atypical carcinoid tumour). Sixteen patients (26.7%) had received neoadjuvant therapy. Fifty-four patients (90.0%) had complete resection. The overall agreement between the r-stage and p-stage was 66.7% (κ = 0.46) for TNM staging and 46.7% (κ = 0.30) for modified Masaoka staging. Agreement between r-assessment and p-assessment of the T, N and M components of the TNM stage was 61.7% (κ = 0.28), 86.7% (κ = 0.48) and 98.3% (κ = 0.88), respectively. CT overstaged 12 patients (20.0%) for TNM staging and 12 patients (20.0%) for modified Masaoka staging and understaged 8 (13.3%) and 20 (33.3%) patients for TNM staging modified Masaoka staging, respectively. The r-TNM staging accuracy was lower for patients with neoadjuvant therapy (50.0% with vs 72.7% without). During a median follow-up of 2.6 years (range 0.1–10.5 years), 12 patients had metastases and/or recurrence; 11 patients died (4 of disease). The r-TNM stage and modified Masaoka stage were associated with overall survival and progression-free survival (P < 0.001). CONCLUSIONS Preoperative chest CT is able to accurately predict p-TNM stage in two-thirds of surgically resected TET, with an agreement between radiological staging and pathological staging superior to the modified Masaoka staging.

Preoperative chest computed tomography in emergency surgery during COVID-19 pandemic

2021 ◽  
pp. 175045892110244
Author(s):  
Vasiliki Chatzaraki ◽  
Rahel A Kubik-Huch ◽  
Anna Potempa ◽  
Andi Gashi ◽  
Andrée Friedl ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Surgery ◽  
Clinical Symptoms ◽  
Preoperative Assessment ◽  
Rt Pcr ◽  
Chest Computed Tomography ◽  
Negative Results ◽  
Computed Tomography Images ◽  
Preoperative Chest

Background The COVID-19 pandemic challenges the recommendations for patients’ preoperative assessment for preventing severe acute respiratory syndrome coronavirus type 2 transmission and COVID-19-associated postoperative complications and morbidities. Purpose To evaluate the contribution of chest computed tomography for preoperatively assessing patients who are not suspected of being infected with COVID-19 at the time of referral. Methods Candidates for emergency surgery screened via chest computed tomography from 8 to 27 April 2020 were retrospectively evaluated. Computed tomography images were analysed for the presence of COVID-19-associated intrapulmonary changes. When applicable, laboratory and recorded clinical symptoms were extracted. Results Eighty-eight patients underwent preoperative chest computed tomography; 24% were rated as moderately suspicious and 11% as highly suspicious on computed tomography. Subsequent reverse transcription polymerase chain reaction (RT-PCR) was performed for seven patients, all of whom tested negative for COVID-19. Seven patients showed COVID-19-associated clinical symptoms, and most were classified as being mildly to moderately severe as per the clinical classification grading system. Only one case was severe. Four cases underwent RT-PCR with negative results. Conclusion In a cohort without clinical suspicion of COVID-19 infection upon referral, preoperative computed tomography during the COVID-19 pandemic can yield a high suspicion of infection, even if the patient lacks clinical symptoms and is RT-PCR-negative. No recommendations can be made based on our results but contribute to the debate.

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