Japanese Journal of Radiology

, 27:416 | Cite as

Size of noncancerous hilomediastinal lymph nodes measured on coronal and sagittal reconstruction CT images

  • Mizue HasegawaEmail author
  • Fumikazu Sakai
  • Fumiko Kimura
  • Kaiji Inoue
  • Atsushi Nagai
Original Article



To determine the sizes of hilomediastinal lymph nodes on coronal and sagittal reconstruction computed tomographic images of subjects without known malignancies.

Materials and methods

We evaluated 560 lymph nodes of 246 consecutive patients who underwent multidetector-row computed tomography (MDCT) of the chest, then reconstructed coronal and sagittal images on a viewer and measured short-axis diameters of lymph nodes in each station according to the American Thoracic Society (ATS) map for axial, coronal, and sagittal images.


On coronal images, short-axis diameters were signifi cantly larger than on axial images in station #4R (P < 0.01). On sagittal images, short-axis diameters were signifi cantly smaller than on axial images in stations #4L (P < 0.01), #10R (P < 0.001), and #10L (P < 0.05). On coronal and sagittal images, short-axis diameters were signifi cantly smaller than on axial images in stations #11R (P < 0.001). In #7, diameters were signifi cantly larger on coronal images than on axial and sagittal images (P < 0.001), and diameters were signifi cantly smaller on sagittal images than on axial images (P < 0.01).


In stations #4R, #4L, #7, #10R, #10L, and #11R, measurements of short-axis diameters of hilomediastinal lymph nodes differed on coronal and sagittal images. On coronal and sagittal images, evaluation of hilomediastinal lymph nodes requires unique size criteria for every station.

Key words

Hilomediastinal lymph nodes Multidetector-row CT Size 


  1. 1.
    Spira A, Ettinger DS. Multidisciplinary management of lung cancer. N Engl J Med 2004;350:379–392.CrossRefPubMedGoogle Scholar
  2. 2.
    Toloza EM, Harpole L, Detterbeck F, McCrory DC. Invasive staging of non-small cell lung cancer. Chest 2003;123(1 suppl):157–166s.CrossRefGoogle Scholar
  3. 3.
    Kernstine KH, Stanford W, Mullan BF, Rossi NP, Thompson BH, Bushnell DL, et al. PET, CT, and MRI with Combidex for mediastinal staging in non-small cell lung carcinoma. Ann Thorac Surg 1999;68:1022–1028.CrossRefPubMedGoogle Scholar
  4. 4.
    Prenzel KL, Mönig SP, Sinning JM, Baldus SE, Brochhagen HG, Schneider PM, et al. Lymph node size and metastatic infi ltration in non-small cell lung cancer. Chest 2003;123:463–467.CrossRefPubMedGoogle Scholar
  5. 5.
    Sioris T, Järvenpää R, Kuukasjärvi P, Helin H, Saarelainen S, Tarkka M. Comparison of computed tomography and systematic lymph node dissection in determining TNM and stage in non-small cell lung cancer. Eur J Cardiothorac Surg 2003;23:403–408.CrossRefPubMedGoogle Scholar
  6. 6.
    Vansteenkiste JF, Stroobants SG, De Leyn PR, Dupont PJ, Bogaert J, Maes A, et al. Lymph node staging in non-smallcell lung cancer with FDG-PET scan: a prospective study on 690 lymph node stations from 68 patients. J Clin Oncol 1998;16:2142–2149.PubMedGoogle Scholar
  7. 7.
    Scott WJ, Gobar LS, Terry JD, Dewan NA, Sunderland JJ. Mediastinal lymph node staging of non-small-cell lung cancer: a prospective comparison of computed tomography and positron emission tomography. J Thorac Cardiovasc Surg 1996;111:642–648.CrossRefPubMedGoogle Scholar
  8. 8.
    American Thoracic Society. Medical section of the American Lung Association. Clinical staging of primary lung cancer. Am Rev Respir Dis 1983;127:659–664.Google Scholar
  9. 9.
    The Japan Lung Cancer Society. General rule for clinical and pathological record of lung cancer, 6th edn. Tokyo: Kanehara;2003.Google Scholar
  10. 10.
    Kramer H, Groen HJ. Current concepts in the mediastinal lymph node staging of nonsmall cell lung cancer. Ann Surg 2003;238:180–188.PubMedGoogle Scholar
  11. 11.
    Glazer GM, Gross BH, Quint LE, Francis IR, Bookstein FL, Orringer MB. Normal mediastinal lymph nodes: number and size according to American Thoracic Society mapping. Am J Roentgenol AJR 1985;144:261–265.Google Scholar
  12. 12.
    Gress FG, Savides TJ, Sandler A, Kesler K, Conces D, Cummings O, et al. Endoscopic ultrasonography, fi ne-needle aspiration biopsy guided by endoscopic ultrasonography, and computed tomography in the preoperative staging of nonsmall-cell lung cancer: a comparison study. Ann Intern Med 1997;127:604–612.PubMedGoogle Scholar
  13. 13.
    Pieterman RM, van Putten JW, Meuzelaar JJ, Mooyaart EL, Vaalburg W, Koëter GH, et al. Preoperative staging of nonsmall-cell lung cancer with positron-emission tomography. N Engl J Med 2000;343:254–261.CrossRefPubMedGoogle Scholar
  14. 14.
    Gould MK, Kuschner WG, Rydzak CE, Maclean CC, Demas AN, Shigemitsu H, et al. Test performance of positron emission tomography and computed tomography for mediastinal staging in patients with non-small-cell lung cancer: a meta-analysis. Ann Intern Med 2003;139:879–892.PubMedGoogle Scholar
  15. 15.
    Toloza EM, Harpole L, McCrory DC. Noninvasive staging of non-small cell lung cancer. Chest 2003;123:137–146.CrossRefGoogle Scholar
  16. 16.
    Yasufuku K, Nakajima T, Motoori K, Sekine Y, Shibuya K, Hiroshima K, et al. Comparison of endobronchial ultrasound, positron emission tomography, and CT for lymph node staging of lung cancer. Chest 2006;130:710–718.CrossRefPubMedGoogle Scholar
  17. 17.
    Wahl RL, Quint LE, Greenough RL, Mayer CR, White RI, Orringer MB. Staging of mediastinal non-small cell lung cancer with FDG PET, CT, and fusion images: preliminary prospective evaluation. Radiology 1994;191:371–377.PubMedGoogle Scholar
  18. 18.
    Shim SS, Lee KS, Kim BT, Chung MJ, Lee EJ, Choi JY, et al. Non-small cell lung cancer: prospective comparison of integrated FDG PET/CT and CT alone for preoperative staging. Radiology 2005;236:1011–1019.CrossRefPubMedGoogle Scholar
  19. 19.
    Tournoy KG, Maddens S, Gosselin R, Van Maele G, van Meerbeeck JP, Kelles A. Integrated FDG-PET/CT does not make invasive staging of the intrathoracic lymph nodes in non-small cell lung cancer redundant: a prospective study. Thorax 2007;62:696–701.CrossRefPubMedGoogle Scholar
  20. 20.
    Kim BT, Lee KS, Shim SS, Choi JY, Kwon OJ, Kim H, et al. Stage T1 non-small cell lung cancer: preoperative mediastinal nodal staging with integrated FDG PET/CT-a prospective study. Radiology 2006;241:501–509.CrossRefPubMedGoogle Scholar
  21. 21.
    Nguyen BC, Stanford W, Thompson BH, Rossi NP, Kernstine KH, Kern JA, et al. Multicenter clinical trial of ultrasmall superparamagnetic iron oxide in the evaluation of mediastinal lymph nodes in patients with pulmonary lung carcinoma. J Magn Reson Imaging 1999;10:468–473.CrossRefPubMedGoogle Scholar
  22. 22.
    Kiyono K, Sone S, Izuno I, Sakai F, Oguchi M, Imai S, et al. Size of normal hilar lymph nodes measured in autopsy specimens. Acta Radiol 1989;30:471–474.CrossRefPubMedGoogle Scholar
  23. 23.
    Shimoyama K, Murata K, Takahashi M, Morita R. Pulmonary hilar lymph node metastasis from lung cancer: evaluation based on morphology at thin-section, incremental, dynamic CT. Radiology 1997;203:187–195.PubMedGoogle Scholar

Copyright information

© Japan Radiological Society 2009

Authors and Affiliations

  • Mizue Hasegawa
    • 1
    Email author
  • Fumikazu Sakai
    • 1
  • Fumiko Kimura
    • 1
  • Kaiji Inoue
    • 1
  • Atsushi Nagai
    • 2
  1. 1.Department of Diagnostic Radiology, Saitama International Medical CenterSaitama Medical UniversityHidakaJapan
  2. 2.First Department of MedicineTokyo Women’s Medical UniversityTokyoJapan

Personalised recommendations