PURPOSE: To evaluate the detection of small peripheral lung tumors on chest radiographs on the basis of the size of the tumor and its extent of ground-glass opacity (GGO) at thin-section computed tomography (CT).
MATERIALS AND METHODS: Chest radiographs of 75 patients with peripheral carcinomas 20 mm in diameter or smaller (26 localized bronchioloalveolar carcinomas [BACs], 49 other carcinomas) and 60 normal chest radiographs were retrospectively reviewed individually by 10 radiologists. The extent of GGO within the lesions at thin-section CT was reviewed retrospectively. The detection rates for localized BAG and other carcinomas on chest radiographs were calculated and were correlated with tumor size and extent of GGO.
RESULTS: The mean sensitivity for detection of small peripheral carcinomas was 58.5% � 8.8 (standard error) for localized BAG and was 78.6% � 5.1 for other carcinomas (P = .024). Lesions that were smaller than 15 mm in diameter and had an extent of GGO of 70% or greater at thin-section CT were more difficult to detect than tumors that had larger diameters or less extensive GGO (x2 = 8.13, df= 1, P = .004).
CONCLUSION: The detection of small peripheral carcinomas on chest radiographs is influenced by tumor size and extent of GGO as seen at thin-section CT.