Accuracy of Computerised Tomography Scan for the Diagnosis of Lymph Node Metastasis in Cholangiocarcinoma
Introduction: Lymph Node Metastasis (LNM) is the most unfavourable outcome and a criterion of inoperability in Cholangiocarcinoma (CCA). Computerised Tomography (CT) scans are commonly used for preoperative evaluation of LNM. However, the accuracy of CT scan in LNM detection has not been clearly eva...
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doaj-2f291e2bc11c433ab7546832b19cc8e22020-11-25T03:31:59ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2018-02-01122PC12PC1610.7860/JCDR/2018/34033.11196Accuracy of Computerised Tomography Scan for the Diagnosis of Lymph Node Metastasis in CholangiocarcinomaMetha Songthamwat0Nitaya Chamadol1Narong Khuntikeo2Jadsada Thinkhamrop3Supinda Koonmee4Nathaphop Chaichaya5Bandit Thinkhamrop6PhD Student, Department of Epidermiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.Professor, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.Associate Professor, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.Professor, Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.Associate Professor, Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.PhD Student, Department of Epidermiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.Associate Professor, Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.Introduction: Lymph Node Metastasis (LNM) is the most unfavourable outcome and a criterion of inoperability in Cholangiocarcinoma (CCA). Computerised Tomography (CT) scans are commonly used for preoperative evaluation of LNM. However, the accuracy of CT scan in LNM detection has not been clearly evaluated. Aim: The aim of this study was to evaluate the accuracy of CT scan for preoperative LNM detection in CCA. Materials and Methods: This diagnostic test study was based on an ongoing prospective cohort study (Cholangiocarcinoma Screening and Care Program, CASCAP) in nine tertiary care hospitals in the Northeastern region of Thailand. The subjects were patients with suspected CCA based on ultrasound examination. CT scan was done to evaluate the lesion and LNM. For operable subjects, the lymph nodes were dissected and sent for pathological diagnosis. The results were then compared with the radiographic results. Results: The CT scan accurately detected the presence or absence of LNM in 78 of 127 CCA subjects (61.4%, 95% CI 52.4-69.9), resulting in a sensitivity of 50.8% (95% CI 37.9-63.6) and a specificity of 71.9% (95% CI 59.2-82.4). The positive and negative predictive values were 64.0% (95% CI: 49.2-77.1) and 59.7% (95% CI: 47.9-70.8), respectively. The positive likelihood ratio was 1.81 (95% CI: 1.14-2.86) and the negative likelihood ratio was 0.69 (95% CI: 0.51-0.92). Conclusion: The CT scan has limited accuracy in the preoperative diagnosis of LNM. Therefore, surgeons should be aware of the number of false positives in determining inoperable patients.https://jcdr.net/articles/PDF/11196/34033_F(SHU)_PF1(MJ_AnG_OM)_PFA(MJ_SL).pdfbile duct cancerpreoperativeradiographic diagnosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Metha Songthamwat Nitaya Chamadol Narong Khuntikeo Jadsada Thinkhamrop Supinda Koonmee Nathaphop Chaichaya Bandit Thinkhamrop |
spellingShingle |
Metha Songthamwat Nitaya Chamadol Narong Khuntikeo Jadsada Thinkhamrop Supinda Koonmee Nathaphop Chaichaya Bandit Thinkhamrop Accuracy of Computerised Tomography Scan for the Diagnosis of Lymph Node Metastasis in Cholangiocarcinoma Journal of Clinical and Diagnostic Research bile duct cancer preoperative radiographic diagnosis |
author_facet |
Metha Songthamwat Nitaya Chamadol Narong Khuntikeo Jadsada Thinkhamrop Supinda Koonmee Nathaphop Chaichaya Bandit Thinkhamrop |
author_sort |
Metha Songthamwat |
title |
Accuracy of Computerised Tomography Scan for the Diagnosis of Lymph Node Metastasis in Cholangiocarcinoma |
title_short |
Accuracy of Computerised Tomography Scan for the Diagnosis of Lymph Node Metastasis in Cholangiocarcinoma |
title_full |
Accuracy of Computerised Tomography Scan for the Diagnosis of Lymph Node Metastasis in Cholangiocarcinoma |
title_fullStr |
Accuracy of Computerised Tomography Scan for the Diagnosis of Lymph Node Metastasis in Cholangiocarcinoma |
title_full_unstemmed |
Accuracy of Computerised Tomography Scan for the Diagnosis of Lymph Node Metastasis in Cholangiocarcinoma |
title_sort |
accuracy of computerised tomography scan for the diagnosis of lymph node metastasis in cholangiocarcinoma |
publisher |
JCDR Research and Publications Private Limited |
series |
Journal of Clinical and Diagnostic Research |
issn |
2249-782X 0973-709X |
publishDate |
2018-02-01 |
description |
Introduction: Lymph Node Metastasis (LNM) is the most unfavourable outcome and a criterion of inoperability in Cholangiocarcinoma (CCA). Computerised Tomography (CT) scans are commonly used for preoperative evaluation of LNM. However, the accuracy of CT scan in LNM detection has not been clearly evaluated. Aim: The aim of this study was to evaluate the accuracy of CT scan for preoperative LNM detection in CCA. Materials and Methods: This diagnostic test study was based on an ongoing prospective cohort study (Cholangiocarcinoma Screening and Care Program, CASCAP) in nine tertiary care hospitals in the Northeastern region of Thailand. The subjects were patients with suspected CCA based on ultrasound examination. CT scan was done to evaluate the lesion and LNM. For operable subjects, the lymph nodes were dissected and sent for pathological diagnosis. The results were then compared with the radiographic results. Results: The CT scan accurately detected the presence or absence of LNM in 78 of 127 CCA subjects (61.4%, 95% CI 52.4-69.9), resulting in a sensitivity of 50.8% (95% CI 37.9-63.6) and a specificity of 71.9% (95% CI 59.2-82.4). The positive and negative predictive values were 64.0% (95% CI: 49.2-77.1) and 59.7% (95% CI: 47.9-70.8), respectively. The positive likelihood ratio was 1.81 (95% CI: 1.14-2.86) and the negative likelihood ratio was 0.69 (95% CI: 0.51-0.92). Conclusion: The CT scan has limited accuracy in the preoperative diagnosis of LNM. Therefore, surgeons should be aware of the number of false positives in determining inoperable patients. |
topic |
bile duct cancer preoperative radiographic diagnosis |
url |
https://jcdr.net/articles/PDF/11196/34033_F(SHU)_PF1(MJ_AnG_OM)_PFA(MJ_SL).pdf |
work_keys_str_mv |
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