Role of computerized tomography in assessment of the mediastinum in patients with lung carcinoma.

Over a 28 months period, 75 patients with pathologically confirmed lung carcinoma had computerized tomographic scanning of the mediastinum as a staging procedure. The scan had a sensitivity of 85 percent and a specificity of 89 percent for mediastinal lymph node metastases, making routine mediastinoscopy unnecessary. Tissue confirmation of most positive scans is advisable since false-positive results can deny some patients potentially curative resection. Invasive staging should also be employed in the face of negative scans in selected patients. Computerized tomographic scanning provides anatomic information that is helpful in directing these invasive staging procedures.