119ACCURACY OF TRANSTHORACIC ULTRASOUND FOR THE PREDICTION OF CHEST WALL INFILTRATION BY LUNG CANCER AND OF LUNG INFILTRATION BY CHEST WALL TUMOURS

Objectives: The aim of this study is to determine the accuracy of transthoracic ultrasound (US) in the prediction of chest wall infiltration by lung cancer or lung infiltration by chest wall tumours. Methods: Twenty-three patients with preoperative CT-scan suspect for lung/chest wall infiltration underwent preoperative transthoracic US. Previsions were checked during surgical intervention. Body mass index (BMI) and chronic obstructive pulmonary disease (COPD) were also evaluated as potential confounders. Results: Sixteen men and 7 women affected by lung cancer (n = 14: NSCLC n = 13, metastasis n = 1) or chest wall tumour (n = 9: primitive n = 4, secondary n = 5) were preoperatively examined. Mean BMI, FEV1, FEV1/FVC and tumour size were 26 kg/m2, 89.5%, 72.9% and 5.4 cm, respectively. Sensitivity and specificity of transthoracic US in predicting infiltration were 88.89% and 100%, respectively. Positive and negative predictive values were 100% and 93.3%, respectively. Accuracy was 95.7%. ROC curve analysis was used to determine the best cut-off for tumour size to predict lung/chest wall infiltration: 4.5 cm [CI 95% (2.8–4.5)]. On univariate analysis US (P < 0.001) and tumour size (