Transoesophageal sonography in the staging of lung cancer

Cancer: Purpose: The usefulness of transesophageal sonography in staging lung cancer was examined. Method: Transoesophageal sonography was performed in 15 patients as a staging examination using either biplane or multiplane technique. The results were compared with other radiological techniques such as computed tomography and, if performed, with the findings in the operation. Results: The neoplastic mass was correctly identified in 12 of the 15 patients. Transoesophageal sonography is a very useful examination, more so than computed tomography, for identification of a tumour infiltration into great Vessels or cardiovascular structures. In 8 cases we found para-aortal tumour masses and in 4 cases infiltration of the pulmonary artery. In 2 cases we could show an infiltration of heart chambers. The sensitivity for detecting lymph nodes was 80% in the lower mediastinum and, because of method limitations, only 33% in the upper mediastinum. Conclusion: Transoesophageal sonography is an excellent addition to the already well established staging methods in staging lung cancer. This examination clearly has advantages over the conventional methods (CT scan) for the diagnosis of vessel involvement, extrinsic compression of the heart, and for the recognition of lymph node metastases. The limitation of this examination is the restriction to the paraoesophageal area and reduced effectiveness in areas filled with air and other nonconductive structures.