Radiological Evaluation of Lung Tumor Size

Two board certified chest radiologists with more than 20 years experiences reviewed all CT images and classified the background lung according to eight patterns; normal lung, bronchiectasis, consolidation, emphysema, ground-glass opacity, honeycombing, nodular lesion, reticulation based on the glossary of Flesichner Society (10 (link)). Preoperative tumor size was determined based on radiological reports from at least two radiologists. The largest diameters were measured on 0.5–7.0-mm CT images at axial plane with or without 0.5–5.0-mm multiplanar reconstruction (MPR) images at coronal or sagittal planes with lung window setting (width, 1,600 HU; level, −600 HU). Tumors close to the chest wall and mediastinum were also measured at a mediastinal window setting (width, 300 HU; level, 30 HU). These measurements were also checked in our thoracic surgeon conferences. We restaged the cases after 2018 according to the 7^th Edition of TNM in Lung Cancer of International Association for Study of Lung Cancer (IASLC).