SYNOPSIS

Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore

“ROLE OF MULTI DETECTOR COMPUTED TOMOGRAPHY IN EVALUATION AND STAGING OF BRONCHOGENIC CARCINOMA”

Name of the candidate : DR.TESSA JOSE

Guide : DR.UDAY SHANKAR BHAT

M.D, DNB

Course and subject : M.D (Radio Diagnosis)

Department of Radio Diagnosis,

Father Muller Medical College,

Kankanady, Mangalore – 575002.

August - 2010

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

ANNEXURE – II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION.

1.  / NAME OF THE CANDIDATE AND ADDRESS [IN BLOCK LETTERS] / DR.TESSA JOSE
POST GRADUATE RESIDENT,
DEPARTMENT OF RADIO DIAGNOSIS,
FR.MULLER MEDICAL
COLLEGE,KANKANADY,
MANGALORE-2.
2.  / NAME OF THE INSTITUTION / FR.MULLER MEDICAL COLLEGE,KANKANADY,
MANGALORE – 575002.
3.  / COURSE OF STUDY AND SUBJECT / M.D ( RADIO DIAGNOSIS )
4.  / DATE OF ADMISSION TO THE COURSE / 30-04-2010
5.  / TITLE OF THE TOPIC:
“ ROLE OF MULTI DETECTOR COMPUTED TOMOGRAPHY IN EVALUATION AND STAGING OF BRONCHOGENIC CARCINOMA”
6.  / BRIEF RESUME OF THE INTENDED WORK:
6.1.  NEED FOR THE STUDY:
Bronchogenic carcinoma is the single most devastating cause of cancer-related
deaths with approximately 1.5 million cases1 world-wide and more than 1.3 million cancer related deaths in 2001.A recent study showed that lung cancer accounts for 7.4% of total cancer incidence in India2. The prevention and early diagnosis of lung cancer thus assumes a major public health issue.
Imaging plays a crucial role in the management of patients with bronchogenic carcinoma.The role of imaging2 ranges from screening for lung cancer in high risk individuals to diagnosis and staging of bronchogenic carcinoma.
Multidetector computed tomography (MDCT) is the modality2 of choice for evaluating bronchogenic carcinoma .It identifies small nodules5 not visible by radiography.Besides, it also has a role in characterizing them as benign or malignant. MDCT accurately stages the tumor because of the superior multiplanar reformatted5 images.Staging of bronchogenic carcinoma plays a very important role in deciding the treatment and also helps in assessing the prognosis.
The present study is aimed at evaluating the imaging characteristics of bronchogenic carcinoma by MDCT with histopathological correlation, its diagnostic accuracy and effectiveness in staging.
6.2.  REVIEW OF LITERATURE:
C.M Shetty and his colleagues2 studied the various CT appearances of bronchogenic carcinoma and concluded that MDCT is the modality of choice for evaluating bronchogenic carcinoma and provides precise characterization of the size, contour, extent and tissue composition of the suspicious lesion.
Suliman and his associates3 studied the frequency of various histological types of bronchogenic carcinoma and concluded that squamous cell carcinoma is the commonest variety.
Rawat and his associates4 studied the clinico-pathological profile of lung cancer and concluded that squamous cell carcinoma was the most frequent histopathological form.
Mahmood and Suresh5 studied the role of MDCT for revised TNM staging of non small cell carcinoma of the lung and concluded that MDCT is an accurate tool for NSCLC staging.
6.3.  OBJECTIVES OF THE STUDY:
1.  To assess the diagnostic accuracy of multi detector computed tomography in evaluation of bronchogenic carcinoma.
2.  To document the various CT appearances of bronchogenic carcinoma with histopathological correlation.
3.  To assess the effectiveness of MDCT in staging bronchogenic carcinoma.
7.  / MATERIALS AND METHODS:
7.1.  SOURCE OF DATA:
This is a diagnostic study. A minimum of thirty patients with clinical or radiological suspicion of bronchogenic carcinoma referred for CT scan of thorax to the Department of Radio Diagnosis, Father Muller Medical College will be taken.
The study will be done over a period of 2 years from May 2010 to May 2012.
7.2.  METHOD OF COLLECTION OF DATA:
Data will be collected from a minimum of thirty cases with suspected bronchogenic carcinoma referred for CT scan of thorax by purposive sampling using a proforma.
All scans are done using GE bright speed 16 slice MDCT with 120 KVp and 300 mAs with 5mm section thickness, retro reconstruction of 0.625mm section thickness and reformation. Contrast study is done using 70-80 ml of 350mg/ml non-ionic iodinated contrast, injected using pressure injector at the rate of 3-4ml/s. Sections are taken from the level of lung apices to the diaphragm routinely including the liver and adrenals.
Lung lesions are characterised based on the site, size, enhancement pattern, presence of calcification, cavitation, involvement of the hila , pleura , chest wall or mediatsinum. MDCT findings are correlated with histopathological examination of the specimen obtained from FNAC / biopsy of the lesion.
PLAN FOR DATA ANALYSIS - Collected data will be analysed by sensitivity, specificity, positive predictive value and by chi-square test.
INCLUSION CRITERIA:
1.  Patients with clinically or radiologically suspected bronchogenic carcinoma.
2.  Patients in whom histopathological correlation is available.
EXCLUSION CRITERIA:
1.  Patients in whom histopathological correlation is not available.
7.3.  Does the study require any investigations or interventions to be conducted on patients or other humans or animals? If so describe briefly.
Yes. All patients selected for the study will require contrast enhanced CT scan of thorax for evaluating the lung lesion. The study also requires CT guided FNAC or biopsy from the lesion for histopathological correlation.
7.4.  Has ethical clearance been obtained from your institution in case of 7.3
Yes.
8. / LIST OF REFERENCES:
1.  Behera D and Balamugesh T. Lung cancer in India.
Indian J Chest Dis Allied Sci 2004 ; 46 : 269-281.
2.  Shetty C.M , Lakhkhar B.N , Gangadhar V.S.S, Ramachandran
N.R. Changing pattern of bronchogenic Carcinoma : A
Statistical Variation Or Reality. Indian J Radiol Imaging 2005 ;
15 (1) : 233-238.
3.  Suliman Muhammad Imran , Jibran Rushd , Majeed Muhammad Zafar. Demographics Of Bronchogenic Carcinoma Patients And Frequency Of Cell Types. Gomal J Med Sci Jan-June 2006; 4 (1) : 2-6.
4.  Rawat J , Sindhwani G , Gaur D , Dua R , Saini S.
Clinicopathological Profile Of Lung Cancer In Uttarakhand .
Lung India 2009 ; 26 : 74-6.
5.  Mahmood N.S and Suresh H.B. Multidetector Computed
Tomography Findings In The Revised Tumor , Nodal And
Metastasis Staging Of Non Small Cell Carcinoma Of The
Lung : A Pictorial Essay. Iran J Radiol 2010 ; 7 (1) : 17-22.
9. / SIGNATURE OF THE CANDIDATE
10. / REMARKS OF THE GUIDE / Study can be conducted.
11. / 11.1 NAME AND DESIGNATION OF GUIDE
(in block letters) / DR. UDAYSHANKAR BHAT
M.D,DNB.
ASSOCIATE PROFESSOR
DEPARTMENT OF RADIODIAGNOSIS
FR.MULLER MEDICALCOLLEGE,
KANKANADY,
MANGALORE.
11.2 SIGNATURE
11.3 CO- GUIDE (if any) / -
11.4 SIGNATURE / -
11.5 HEAD OF THE DEPARTMENT / DR. VINOD HEGDE
M.D
PROFESSOR & H.O.D
DEPARTMENT OF RADIODIAGNOSIS
FR.MULLER COLLEGE MEDICAL,KANKANANDY,
MANGALORE.
11.6 SIGNATURE
12. / 12.1 REMARKS OF THE CHAIRMAN AND PRINCIPAL
12.2 SIGNATURE

5