CT of mediastinal lymph nodes in lung cancer: is there a "state of the art"?

As our technology improves, much of what has been done must be reevaluated. Initial reports of new techniques often are glowing, with nay-sayers in the minority. The use of computed tomography (CT) in the evaluation of mediastinal lymph nodes in lung cancer may be a case in point. Reported accuracy rates and utility vary appreciably. On careful inspection of the reports, none are structured the same way. These differences raise significant questions. Do we have satisfactory criteria. How accurate is CT. When should CT be used. Of what use is the information. This editorial examines eight studies published since 1980 to see if the questions raised above could be answered. The year 1980 was chosen to ensure that sufficient time had elapsed to reflect a more general experience. Only CT evaluation of mediastinal lymph nodes was considered.