372
Letters
J Am Coll Surg
Second, tumor density strongly and inversely correlated with larger tumors, and decreasing density was associated with increased aggressiveness. But they suggest that high tumor density may be specific for malignancy. How do the authors reconcile these observations? Third, the authors note that a density cut-off of 200 (presumably Hounsfield units?) was 75% specific for malignant tumors. We would like to respectfully raise the question, “Is 75% a clinically useful specificity?” Many, if not most, tests currently in clinical use have vastly higher specificities (eg PCR for C diff, 99%3; CT for pulmonary embolism (PE), >90% to 95%4,5; CT for appendicitis,
Letters
J Am Coll Surg
Second, tumor density strongly and inversely correlated with larger tumors, and decreasing density was associated with increased aggressiveness. But they suggest that high tumor density may be specific for malignancy. How do the authors reconcile these observations? Third, the authors note that a density cut-off of 200 (presumably Hounsfield units?) was 75% specific for malignant tumors. We would like to respectfully raise the question, “Is 75% a clinically useful specificity?” Many, if not most, tests currently in clinical use have vastly higher specificities (eg PCR for C diff, 99%3; CT for pulmonary embolism (PE), >90% to 95%4,5; CT for appendicitis,
