Lateral chest radiography in the screening of pulmonary metastasis in osteosarcoma patients

Abstract

Background: No previous study has mentioned the value of lateral chest radiography in the screening of pulmonary metastasis from osteosarcoma. We assume that lateral chest radiography gives no additional information that would be clinically significant compared with the frontal view alone.

Objectives: This study aimed to evaluate the value of lateral chest radiography in the screening of pulmonary metastasis in patients with osteosarcoma.

Methods: In total, 400 sets of chest radiographs [posterior-anterior (PA) and lateral projections] were interpreted by a single radiologist for pulmonary mass/nodule, lymph node, and pneumothorax. First, the PA radiographs were interpreted. Thereafter, the PA and lateral radiographs were analyzed together with a specific note made whether any findings were identifiable only on the lateral radiograph or if it was on both views. Then, a determination was made in all cases whether the findings on the lateral radiograph changed the diagnosis made based on the PA radiograph alone.

Results: The PA and lateral chest radiographs showed abnormalities in 80 (20.0%) of the 400 sets of radiographs. There were the abnormalities observed only on the lateral radiographs in 5 sets (6.3%), 4 sets (22.2%), and 0 sets for mass/nodule, lymph node, and pneumothorax, respectively. There was no statistically significant difference between the PA radiographs alone and the combination of PA and lateral radiographs in the detection of abnormalities and in the imaging diagnosis of pulmonary metastasis. However, there are three cases which the abnormalities noted on the lateral radiographs change the diagnosis and alter the further management.

Conclusion: Most abnormal findings were identified on the PA images, however, there are the lesions seen only on the lateral images and helped to change the diagnosis and alter further management.