Performance of Radiological Diagnosis of Malignant Lesions of Lung

Background:
Lung cancer is the leading cause of death in Bangladesh especially in
the northern zone. CT guided core biopsy of lung helps in confirming
histopathological diagnosis of lung tumor. Radiological performance for
diagnosing lung malignancies relies on methods like CT, though
sensitivity, specificity, and accuracy can vary based on lesion size and
radiologist experience.
Methods:
This cross-sectional study was conducted at Department of Respiratory
Medicine, Rangpur Medical College, Rangpur, Bangladesh from January
2023 to December 2023 on 102 patients with suspected bronchial
carcinoma. CT scan of chest was performed for all the patients followed
by CT guided core biopsy of lung for histopathology. Sensitivity,
specificity, Positive predictive value (PPV), Negative predictive value
(NPV), and accuracy of radiological diagnosis were calculated.
Results:
Most patients (63%) were aged 51-70, with a male-to-female ratio of
2.6:1. CT scans showed 79% with bronchial neoplasm and 21% with
inflammation. Histopathology revealed 77% had bronchial carcinoma,
with various types identified, Adenocarcinoma (29%), Squamous cell
carcinoma (43%), Small cell carcinoma (16%), neuroendocrine
carcinoma (6%), metastatic leiomyosarcoma (1.2%), metastatic GIST
(1.2%) and undifferentiated carcinoma (1.2%). Sensitivity, specificity,
Positive predictive value (PPV), Negative predictive value (NPV), and
accuracy of radiological diagnosis of bronchial carcinoma were
respectively 100%, 91.3%, 97.5%, 100% and 98.0%.
Conclusion:
CT scan can differentiate malignant lesions from inflammatory lung
lesions with high performance, though histological confirmation of
malignant lesions are mandatory.