Assessment of Chest Radiography and Multislice Computed Tomography in the Diagnosis and Postoperative Monitoring of Pulmonary Masses

Introduction. Chest X-ray (CXR) remains essential for the initial detection of pulmonary neoplasms, particularly in settings with limited access to advanced imaging technologies. Moreover, CXR serves as a screening tool to identify patients who may require further evaluation with multislice computed tomography (MSCT) of the chest to confirm or further assess suspicious pulmonary findings.

Objective. The aim of this study is to assess the informativeness and the clinical and diagnostic value of CXR and MSCT in diagnosing pulmonary masses, as well as their role in postoperative follow-up.

Materials and methods. During a six-month period, 72 patients with suspected pulmonary pathology underwent CXR examinations at the Municipal Non-Profit Enterprise «Mykolaiv Regional Oncology Center». Patient ages ranged from 47 to 79 years (mean age: 69 years), including 24 women and 48 men. All patients initially underwent CXR, and 10 of them were followed up postoperatively using the mobile X-ray system Mobieye 700 (Mindray, China). Contrast-enhanced MSCT of the chest was performed in 12 patients using a Toshiba Aquilion CXL 128-slice scanner (Canon, Japan), based on clinical indications, to confirm the presence of pulmonary masses.

Results. Suspicious pulmonary masses were detected on CXR in 12 patients, prompting further evaluation with MSCT. Contrast-enhanced MSCT confirmed lung masses in 10 patients, while in 2 cases, the presence of masses was ruled out. Among the confirmed cases, 9 were diagnosed with malignant tumors and 1 with a benign lesion identified as a tuberculoma. All 10 patients underwent surgical lobectomy, with histopathological confirmation of the diagnoses. In the postoperative period, all patients were monitored with daily CXR over one week to assess for complications. One patient was diagnosed with right-sided hydrothorax; no radiographic signs of complications were found in the remaining nine patients. This study demonstrates that CXR remains a valuable diagnostic modality for both the initial assessment and postoperative monitoring of pulmonary pathology. The use of a mobile X-ray system allowed effective bedside imaging in the postoperative setting, enabling timely detection of potential complications.

Conclusion. CXR remains a key component in the initial diagnosis and postoperative assessment of pulmonary masses and should be incorporated into a comprehensive diagnostic approach that includes contrast-enhanced MSCT and histological confirmation.