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PURPOSE: To determine if there is a subset of patients undergoing surgical biopsy for diffuse lung disease in whom accurate diagnosis can be made with computed tomography (CT) only. MATERIALS AND METHODS: Two chest radiologists retrospectively reviewed the CT scans of 85 patients in whom surgical biopsy for diffuse lung disease was performed. Thin-section CT images were available in 58 (68%) of the 85 cases. By consensus, the radiologists listed the three most likely diagnoses in order of probability and rated their level of confidence in the first choice. RESULTS: Each of 85 patients with diffuse lung disease had one of 16 diseases. In 79 (93%) cases, the correct diagnosis was one of the three choices. In 54 (64%) cases, the correct diagnosis was the radiologists' first choice. A high level of confidence in the first choice was reached in 20 (24%) cases; all 20 cases were forms of chronic lung disease. In 18 (90%) of these 20 cases, the first choice was correct. CONCLUSION: In a subset of patients with diffuse lung disease who undergo surgical biopsy, accurate diagnosis can be made with CT findings only.
Swensen et al. (Wed,) studied this question.