diagnostic efficacy of cxr compared to chest ct in preoperative staging of patients with colorectal cancer

Background:the high prevalence of colorectal cancer (crc) and its increasing incidence can be a major problem in cancer management. preoperative staging plays a significant role in the therapeutic process, especially in crc which has high risk for lung metastases.objectives:this study aimed to evaluate accuracy of chest xray (cxr) in comparison with chest ct (cct) for diagnosing lung metastases in patients with crc.patients and methods:a cross sectional study was conducted of 377 patients with newly diagnosed crc which were evaluated with cxr and cct.results:cct revealed normal/benign findings in 285 (75.6%), indeterminate nodules in 28 (17%) and suspicious nodules in 64 (17%) patients. although cxr did not reveal any pulmonary metastatic lesions in of the 23 (7%) patients, the measure of agreement between cxr and cct was good (0.64, p <0.01) and cct changed tnm staging in only eight (2%) patients. on logistic regression analysis, liver metastasis could increase the risk of pulmonary metastasis (p <0.01).conclusion:the study suggested cct for preoperative staging in crc patients, especially at stages 3 and 4 in tnm staging and for liver metastases.