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July 1, 1983

Comparison of Computed Tomographic Scans

Author Affiliations

Yakima Valley Memorial Hospital Tumor Center Yakima, Wash

JAMA. 1983;250(1):35. doi:10.1001/jama.1983.03340010021019

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To the Editor.—  The response of a bronchogenic carcinoma to 4,000 rad of external radiation is ostensibly illustrated by sections selected from two sequential computed tomographic (CT) scans of the thorax, as described by Dr Nori and colleagues (1982; 248:2491). It is obvious, however, that the second section, said to show paradoxical destruction of a vertebral body concomitant with a decrease in size of the adjacent soft-tissue mass, is from a slightly different level and is not strictly comparable with the first section. There are at least two other possible interpretations of the second section. (1) Destructive changes were not as clearly shown in the first scan because they "fell through the cracks" between CT slices. (2) The second CT section shows anatomic or positional asymmetry of the vertebral body at its inferior margin and is not showing destruction at all.Care must be exercised in comparing CT scans, which