Clinical and chest radiographic features of missed lung cancer and their association with patient outcomes
3
Issued Date
2023-07-01
Resource Type
ISSN
08997071
eISSN
18734499
Scopus ID
2-s2.0-85153566390
Journal Title
Clinical Imaging
Volume
99
Start Page
73
End Page
81
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Imaging Vol.99 (2023) , 73-81
Suggested Citation
Chutivanidchayakul F., Suwatanapongched T., Petnak T. Clinical and chest radiographic features of missed lung cancer and their association with patient outcomes. Clinical Imaging Vol.99 (2023) , 73-81. 81. doi:10.1016/j.clinimag.2023.03.017 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/82037
Title
Clinical and chest radiographic features of missed lung cancer and their association with patient outcomes
Author's Affiliation
Other Contributor(s)
Abstract
Purpose: To examine clinical and chest radiographic features of missed lung cancer (MLC) and explore their association with patient outcomes. Methods: We retrospectively reviewed chest radiographs obtained at least six months before lung cancer (LC) diagnosis in 95 patients to identify the first positive chest radiograph showing MLC. We assessed chest radiographic features of MLC and their association with patient outcomes. Results: Seventy-five (78.9%) patients (39 men, 36 women; mean age, 64.5 ± 10.5 years) had MLC. The median diagnostic delay was 31.3 months (6.6–128.0 months). The median MLC size was 16 mm (5–57 mm), and 54.7%, 68.0%, and 74.7% of MLC were in the left lung, the middle/lower zones, and the outer two-thirds of the lung, respectively. MLC exhibited a round/oval shape, partly/poorly defined margin, irregular/spiculated border, a density less than the aortic knob, and anatomical superimposition in 57.3%, 77.3%, 61.3%, 85.3%, and 88.0% of cases, respectively. Thirty-five (46.7%) patients had stage III + IV LC at diagnosis. Thirty-one (41.3%) patients died. MLC in the inner one-third of the lung, exhibiting a density equal to/greater than the aortic knob, or superimposed by midline structures was significantly associated with stage III + IV LC at diagnosis. The 3-year all-cause mortality significantly increased when MLC was in the upper zone, superimposed by pulmonary vessels, superimposed by pulmonary vessels plus ribs, or superimposed by pulmonary vessels plus in the inner one-third of the lung. Conclusion: MLC with some radiographic features pertaining to their location, density, and superimposed structures was found to portend a worse outcome.