![]() Computed tomography (CT) has been used as the initial imaging modality for diagnosis and for staging of lymph node metastasis. Nodal staging is an important factor in predicting prognosis and deciding appropriate treatments. Lung cancer is the leading cause of cancer death despite advances in treatment, and its prognosis remains insufficient. ![]() Our method for predicting lymph node metastasis based on sphericity of lymph nodes with a short-axis diameter ≥ 5 mm could do so with higher sensitivity than the conventional method, and with acceptable specificity. Conclusionīy using 3D-CT analysis to examine sphericity, we showed that metastatic lymph nodes became spherical. For lymph nodes with a short-axis diameter ≥ 5 mm, sphericity ≥ 0.60 identified metastasis with 84.1% sensitivity and 89.3% specificity. 0.60, p < 0.001) than those of nonmetastatic lymph nodes. Metastatic lymph nodes had a larger short-axis diameter (average: 8.2 mm vs. Each parameter was obtained and evaluated for ability to predict metastasis. The sphericity of the dissected station lymph nodes, which represents how close the node is to being a true sphere, was evaluated along with the diameter and volume. We reviewed the cases of 66 patients with N2 disease and of 68 patients with N0-1 disease who underwent lobectomy with mediastinal dissection between January 2012 and December 2021. We introduced sphericity as a criterion for evaluating morphologic differences between metastatic and nonmetastatic nodes. Although prevalently used, evaluation of lymph nodes is not always reliable. The presence of mediastinal lymph node metastasis is important because it is related to the treatment and prognosis of lung cancer.
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