Pitfalls in Lung Cancer Assessment With CT

Missed lung cancer on chest radiography and computed tomography

Missed lung cancer raises an important medicolegal issue and contributes to one of the most common causes for malpractice actions against radiologists. Lung cancer may be missed on either chest radiography or computed tomography. Although most malpractice cases involve lesions overlooked on the former, a small and increasing portion of cases are related to chest computed tomography scan. Factors contributing to overlooked lung cancer can be attributed to observer performance, lesion characteristics, and technical considerations.

The imaging manifestations of lung cancer

Imaging plays an integral role in diagnosing, staging, and following patients with lung cancer. Many lung neoplasms are detected on chest radiographs, but the majority of patients have advanced stage disease at the time of presentation. There is a wide spectrum of radiologic manifestations of lung cancer, and recognition of these findings is essential for patient management. As we continue to understand more about tumor biology, new imaging techniques likely will emerge. Nevertheless, the chest radiograph and CT remain important tools in establishing the diagnosis of lung cancer.