Preoperative tomographic assessment of the mediastinum in bronchial carcinoma.

Inclined frontal tomography was introduced into Milford Chest Hospital in 1969 and since that time has been in routine use for the investigation of the mediastinum and for assessing thoracic lymph node metastases in patients with bronchial carcinoma. This paper reports on the correlation of the radiological with the operative findings in 97 patients with histologically proven bronchial carcinoma during 1969 and 1970 and analyses the diagnostic accuracy of the technique. In 1971 it was found that fewer patients were being subjected to palliative pneumonectomy with incomplete resection of malignant tumour and to exploratory thoracotomy. This was thought to be due to the influence of inclined frontal tomography in assessing operability. This was noted particularly in patients whose general condition permitted only a lobectomy and in patients with enlarged paratracheal and subcarinal lymph nodes which were considered to be too extensive for adequate surgical resection. In view of this, further correlation was not undertaken for this series.