0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Reviews |

Standard and Computed Tomography in the Evaluation of Neoplasms of the Chest: A Comparative Efficacy Assessment

SHARON K. INOUYE, M.D.; and HAROLD C. SOX Jr, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Linda Johnson White; Division of Scientific Activities, American College of Physicians, 4200 Pine Street; Philadelphia, PA 19104.


New Haven, Connecticut; and Palo Alto, California


© 1986 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1986;105(6):906-924. doi:10.7326/0003-4819-105-6-906
Text Size: A A A

Although in practice computed tomography (CT) has nearly replaced standard tomography in the evaluation of chest diseases, an analysis of the literature shows that standard tomography may be preferred in some settings. After a detailed review of studies on test performance, we calculated overall sensitivity and specificity values. Using Bayesian analysis, we then developed guidelines for choosing between computed and standard tomography. A test is recommended if its results might obviate the need for an invasive procedure. Standard tomography is recommended in the detection of mediastinal metastases from lung cancer. In the detection of hilar metastases, standard tomography is recommended for patients who have low pretest probabilities of metastases to this site, and computed tomography is recommended for patients who have high pretest probabilities. Computed tomography is recommended for the detection of calcification in solitary pulmonary nodules. Tomographic procedures are not recommended when the pretest probability is intermediate. The discrepancy between current practice and these guidelines highlights the need for carefully designed, multi-institutional comparative studies of radiographic procedures.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)