Radiological Presentation of Lung Cancer Patients at Khartoum Oncology Hospital: A Descriptive Study

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Early diagnosis through radiological imaging is crucial for improving outcomes, yet most patients present at advanced stages. This study aims to evaluate the radiological presentation of lung cancer in patients attending Khartoum Oncology Hospital between April 2022 and October 2022. A descriptive cross-sectional study was conducted on 78 lung cancer patients. Data were collected on demographic characteristics, clinical symptoms, and radiological findings, including chest X-ray (CXR) and computed tomography (CT) scan results. Correlation between clinical features and radiological presentations was analyzed using appropriate statistical tests. Among the 78 patients, 56 (72%) were males, and 22 (28%) were females, with a mean age of 61.2 years. The most common symptoms were cough (87.2%) and dyspnea (55.1%). The duration of symptoms was less than one year in 83.4% of cases. CXR findings revealed mass lesions in 48.7% of patients, pleural effusion in 41%, and atelectasis in 38.5%. CT scans identified mass lesions in 86%, lymph node involvement in 83.3%, and pleural effusion in 59%. Metastatic involvement was detected in 24.4% (liver), 21.8% (bone), and 6.4% (adrenal glands). Centrally located lesions were found in 66.7% of patients, while irregular margins were observed in 64.1% of cases. A statistically significant correlation was found between advanced age and central mass lesions (p < 0.05). The study revealed that lung cancer in Sudanese patients is predominantly diagnosed in males over 60 years of age, with advanced radiological features such as mass lesions, lymph node involvement, and metastasis. The findings highlight the need for early screening and enhanced diagnostic facilities to improve lung cancer detection and management in Sudan. Lung cancer radiological presentation Sudan Khartoum Oncology Hospital CT scan chest X-ray Research Question What are the radiological patterns and clinical characteristics of lung cancer among patients attending Khartoum Oncology Hospital from April 2022 to October 2022? Justification Lung cancer is a major cause of cancer-related mortality worldwide, Despite its prevalence, there is limited data on the radiological presentations and clinical characteristics of lung cancer in Sudanese patients. Radiological imaging, particularly chest X-rays (CXR) and computed tomography (CT) scans, are critical for the diagnosis, staging, and management of lung cancer. Understanding the radiological patterns specific to this population can improve early diagnosis, treatment planning, and patient outcome This study will provide valuable local data on the radiological presentations of lung cancer in Sudan, which may differ from global patterns due to unique environmental, genetic, and social factors. Identifying common radiological patterns in lung cancer can aid clinicians in early detection and intervention, potentially leading to better prognosis and survival rates. Objectives Primary Objective To describe the radiological findings (CXR and CT) in patients diagnosed with lung cancer at Khartoum Oncology Hospital from April 2022 to October 2022 Secondary Objectives To analyze the demographic and clinical characteristics (age, gender, presenting symptoms) of lung cancer patients. To evaluate the distribution of lung cancer in terms of laterality (right lung, left lung, or both) To identify the most common radiological features (mass, pleural effusion, consolidation) on CXR and CT. To determine the frequency of lymph node involvement and other associated findings metastasis, atelectasis) on CT imaging. To assess the relationship between radiological patterns and clinical presentations such as symptom duration and severity. Literature Review Lung cancer remains the leading cause of cancer-related deaths worldwide, accounting for approximately 18% of cancer deaths annually. According to the World Health Organization (WHO), more than 2 million new cases of lung cancer were diagnosed in 2020. Smoking is the most significant risk factor, contributing to about 85% of cases, but other factors like environmental exposure, genetic predispositions, and occupational hazards (such as asbestos and silica) are also important. In Sudan, there is limited epidemiological data on the prevalence of lung cancer. However, anecdotal evidence suggests that the incidence of lung cancer may be increasing, particularly among smokers and individuals exposed to environmental toxins such as those working in mining and construction industries. Radiological imaging plays a critical role in the detection, staging, and management of lung cancer. Chest X-rays (CXR) and computed tomography (CT) are the most common modalities used in initial diagnosis and follow-up. Chest X-ray (CXR): CXR is often the first imaging modality used for patients presenting with symptoms like cough, dyspnoea, and unexplained weight loss. Studies have shown that CXR can detect lung masses, pleural effusions, and signs of advanced disease such as atelectasis or bone involvement. However, CXR is limited in sensitivity, especially for detecting small peripheral lesions or those located behind anatomical structures like the heart or diaphragm. A study by Diederich et al. (2000) found that CXR can miss up to 30% of small lesions that are detectable on CT. However, it remains a valuable initial tool, especially in low-resource settings like Sudan, where access to advanced imaging modalities may be limited. Computed Tomography (CT): CT scans offer more detailed imaging and are superior to CXR in detecting lung masses, lymph node involvement, and metastatic spread. CT can identify the size, location, and margins of lesions, as well as provide crucial information on tumor invasion into adjacent structures like the mediastinum, chest wall, and vascular structures. Studies have shown that CT imaging is essential for determining the stage of lung cancer, which guides treatment decisions. According to The National Comprehensive Cancer Network (NCCN) guidelines, CT is recommended for initial staging and for monitoring response to treatment. CT imaging also plays a key role in identifying mediastinal lymphadenopathy, a common finding in advanced lung cancer, which is critical for determining prognosis. Several studies have examined the radiological presentation of lung cancer. The most common findings include: Masses: Seen in up to 70% of cases, masses are often irregular with spiculated margins, suggesting malignancy. Pleural Effusion: A common finding, particularly in advanced stages, pleural effusions occur in about 30-50% of lung cancer cases, according to Light (2002). Atelectasis: Found in approximately 30-40% of cases, often due to tumor obstruction of airways. Lymph Node Involvement: Mediastinal and hilar lymphadenopathy are present in Lung cancer is the leading cause of cancer-related mortality worldwide, responsible for 18% of all cancer deaths annually. In 2020, over 2 million new cases were diagnosed globally, with smoking being the primary risk factor, contributing to approximately 85% of cases. Other contributing factors include environmental exposures (e.g., radon, asbestos), occupational hazards, and genetic predispositions【1】. In Sudan, although comprehensive data is scarce, lung cancer is suspected to be rising, especially among smokers and individuals exposed to occupational hazards like gold miners and industrial workers. Radiological imaging is fundamental for the diagnosis, staging, and management of lung cancer. Chest X-ray (CXR) and computed tomography (CT) are the two most commonly employed imaging modalities. Chest X-ray (CXR): CXR is often the initial imaging technique used to assess patients with symptoms such as persistent cough, hemoptysis, or unexplained weight loss. Studies have shown that CXR detects masses, pleural effusions, and signs of advanced disease like atelectasis or rib destruction【2】. However, its sensitivity is limited. A study by Diederich et al. found that CXR could miss up to 30% of small lesions that are identifiable on CT【3】. Despite its limitations, CXR remains a valuable tool, especially in resource-limited settings like Sudan, where access to advanced imaging techniques may be restricted. Computed Tomography (CT): CT is far more sensitive and specific than CXR, offering detailed cross-sectional images that allow for better identification of lung masses, mediastinal involvement, and metastatic spread【4】. CT scans play a pivotal role in lung cancer staging, helping to assess tumor size, local invasion, and distant metastasis. According to the National Comprehensive Cancer Network (NCCN) guidelines, CT imaging is essential for accurate staging and guiding treatment【5】. CT also helps in detecting mediastinal lymphadenopathy, a common feature in advanced stages, present in up to 80% of cases【6】. Several studies have reported on the common radiological findings associated with lung cancer. These include masses, nodules, pleural effusions, atelectasis, and lymphadenopathy. Masses: The most common finding in lung cancer is a mass, often with irregular, spiculated margins, suggesting malignancy【7】. Masses are identified in about 70% of patients with lung cancer and are more easily detected on CT than CXR. Pleural Effusion: Pleural effusion is a frequent finding, particularly in advanced cases, and is observed in 30-50% of lung cancer patients【8】. It may indicate either primary lung cancer involvement of the pleura or metastatic disease. Atelectasis: Tumor obstruction of a bronchus can lead to atelectasis, which is seen in 30-40% of lung cancer cases【9】. This finding is more common in centrally located tumors. Lymph Node Involvement: Mediastinal and hilar lymphadenopathy are significant radiological findings, seen in up to 80% of lung cancer cases. The detection of lymph node involvement is crucial for staging and determining the prognosis【10】. Cavitation and Consolidation: Cavitary lesions can be seen in approximately 10-15% of lung cancer cases, often in squamous cell carcinoma【11】. Consolidation is another finding, sometimes associated with lung infection in the context of tumor obstruction. Early detection of lung cancer through imaging can significantly improve treatment outcomes. A study by Aberle et al. demonstrated that low-dose CT screening in high-risk individuals can reduce lung cancer mortality by 20%【12】. Therefore, understanding the common radiological patterns specific to different populations, such as in Sudan, can aid in earlier diagnosis and better management. Study Design This is a descriptive cross-sectional study conducted to analyze the radiological patterns and clinical characteristics of lung cancer patients attending Khartoum Oncology Hospital over a six-month period (April 2022 to October 2022). A retrospective review of medical records and imaging reports (CXR and CT) was performed to gather data. Study Setting The study was conducted at Khartoum Oncology Hospital, one of the major tertiary care centers for cancer diagnosis and treatment in Sudan. This hospital provides a comprehensive range of oncology services, including diagnostic imaging, cancer staging, and therapeutic interventions for lung cancer patients. Study Population The study population consisted of patients diagnosed with lung cancer, confirmed through histopathology, who attended Khartoum Oncology Hospital during the specified period. Inclusion Criteria: All patients diagnosed with lung cancer (histopathologically confirmed). Patients who underwent both chest X-ray (CXR) and computed tomography (CT) scans during the study period. Exclusion Criteria: Patients with incomplete radiological records or those who did not undergo both CXR and CT scans. Patients with other concurrent malignancies affecting lung cancer diagnosis. Sample Size A total of 78 lung cancer patients were included in the study. The sample was based on available medical records from the designated period (April 2022 to October 2022). Data Collection Data were collected retrospectively from patient medical records and radiological reports. This included demographic information, clinical symptoms, and detailed findings from radiological imaging (CXR and CT). Clinical Data: Age, gender, presenting symptoms (e.g., cough, dyspnea), and duration of symptoms. Radiological Data: CXR and CT findings: including lung masses, pleural effusion, consolidation, atelectasis, cavitation, lymph node involvement, and other metastatic signs. CT-specific data: Lesion location (central or peripheral), size, margins (irregular or smooth), and consistency (solid or necrotic). Evidence of lymph node involvement, pleural or pericardial effusion, and distant metastasis ( liver, bone, adrenal glands, brain). Radiological Evaluation CXR Interpretation: A trained radiologist evaluated the chest X-rays for signs of lung masses, pleural effusion, consolidation, atelectasis, and other pathological findings. The affected lung side (right, left, or both) was documented. CT Interpretation : Computed tomography (CT) images were analyzed for the size, location, and nature of the lung lesions. The presence of mediastinal lymphadenopathy, lung nodules, cavitation, and distant metastasis was assessed. Special attention was given to lesion margins (regular vs. irregular), consistency (solid vs. necrotic), and the involvement of adjacent structures (mediastinum, chest wall, etc.). Data Analysis Data were entered into a statistical software program (e.g., SPSS or R) for analysis. Descriptive statistics were used to summarize demographic data, clinical characteristics, and radiological findings. Ethical Considerations Ethical approval for the study was obtained from the Ethical Committee of Sudan medical specialization board. Patient confidentiality was maintained throughout the study by anonymizing the data. No personal identifiers were used in the analysis or reporting of results Since the study was retrospective, no patient consent was required; however, institutional guidelines were followed to ensure the ethical use of patient data. Limitations As a retrospective study, the quality of data depended on the accuracy and completeness of medical records, which may limit the comprehensiveness of the findings. The study was conducted at a single tertiary hospital, and the findings may not be generalizable to all lung cancer patients in Sudan. Not all patients had access to advanced imaging technologies, which could have limited the evaluation of certain radiological features. Results A total of 78 lung cancer patients were included in this study, of which 56 (72%) were males and 22 (28%) were females. The age distribution of the patients showed that 44 (56.4%) were above 60 years, 20 (25.6%) were between 50-60 years, 10 (12.8%) were between 40-49 years, and only 4 (5.1%) were below 40 years. The most common presenting symptom was cough, seen in 68 (87.2%) patients, followed by dyspnea in 43 (55.1%) patients. Other symptoms included weight loss in 30 (38.5%), hemoptysis in 18 (23.1%), and chest pain in 15 (19.2%). The duration of symptoms was less than one year for the majority of patients, with 30 (38.5%) patients having symptoms for less than 6 months, 35 (44.9%) between 6 months to 1 year, and only 13 (16.7%) had symptoms for more than a year. Radiological Findings Chest X-ray Findings: Mass lesions were observed in 38 (48.7%) patients. Pleural effusion was present in 32 (41%). Consolidation was noted in 31 (39.7%). Atelectasis was seen in 30 (38.5%) patients. Other findings included hilar mass (33.3%), mediastinal mass (28.2%), and bony involvement (11.6%). CT Scan Findings: Mass lesions were the most frequent CT finding, identified in 67 (86%) patients. Nodule lesions were found in 11 (14%) patients. Lymph node involvement was noted in 65 (83.3%) patients. Pleural effusion was observed in 46 (59%) patients, and atelectasis was present in 37 (47.4%). Metastatic involvement was also noted, with liver metastasis in 19 (24.4%) patients, bone metastasis in 17 (21.8%), adrenal metastasis in 5 (6.4%), and brain metastasis in 1 (1.3%) patient. Location: Two-thirds of the lesions were centrally located (66.7%), while 33.3% were peripherally located. Mediastinal involvement was seen in 16.7% of centrally located lesions, and chest wall involvement was found in 3.8% of peripheral lesions. Margins: Irregular margins were observed in 50 (64.1%) patients, smooth regular margins in 11 (14.1%), and lobulated regular margins in 17 (21.8%). Consistency: Lesions were uniformly solid in 44 (56.4%) patients and showed central necrosis in 34 (43.6%). A significant correlation was found between age and radiological presentation. Patients above 60 years were more likely to present with mass lesions on both CXR and CT scan (p < 0.05). Additionally, older patients had a higher incidence of pleural effusion and lymph node involvement. There was no statistically significant association between gender and the type of radiological lesion observed on CT (p > 0.05). Patients with symptoms lasting less than one year were more likely to have centrally located lesions and advanced lymph node involvement compared to those with symptoms for over a year (p 60 years 44 (56.4%) 50-60 years 20 (25.6%) 40-49 years 10 (12.8%) Table 2: Clinical Presentation of Lung Cancer Patients Symptom N (%) Cough 68 (87.2%) Dyspnea 43 (55.1%) Weight loss 30 (38.5%) Hemoptysis 18 (23.1%) Chest pain 15 (19.2%) Table 3: Chest X-ray Findings Findings N (%) Mass 38 (48.7%) Pleural effusion 32 (41%) Consolidation 31 (39.7%) Atelectasis 30 (38.5%) Hilar mass 26 (33.3%) Mediastinal mass 22 (28.2%) Bony involvement 9 (11.6%) Table 4: CT Scan Findings Findings N (%) Mass 67 (86%) Nodule 11 (14%) LN involvement 65 (83.3%) Pleural effusion 46 (59%) Atelectasis 37 (47.4%) Liver metastasis 19 (24.4%) Bone metastasis 17 (21.8%) Adrenal metastasis 5 (6.4%) Brain metastasis 1 (1.3%) Discussion The findings of this study highlight the radiological presentation of lung cancer patients in Khartoum Oncology Hospital, with the majority of patients presenting with advanced disease at the time of diagnosis. This section discusses the study results in comparison to similar studies conducted both globally and regionally. In this study, lung cancer was more prevalent among males (72%) than females (28%), with the majority of cases occurring in individuals above 60 years of age (56.4%). This male predominance is consistent with global and regional studies, which attribute this trend largely to higher smoking rates among men. In a study conducted in Saudi Arabia, similar findings were reported, with 76% of lung cancer patients being male, and the majority of cases diagnosed in individuals over the age of 60 years【1】. Additionally, male predominance was observed in a study conducted in Egypt, where 81% of lung cancer patients were men【2】. The higher rates of lung cancer among men in these studies are reflective of known risk factors, including smoking and occupational exposures, which are more common among men in many parts of the world, including Sudan. The most common presenting symptom in this study was cough (87.2%), followed by dyspnea (55.1%). These findings align with studies from other regions where cough and dyspnea are frequently reported as the primary symptoms of lung cancer. In a study conducted by Wang et al. in China, cough was the most common presenting symptom (82%), followed by dyspnea (50%)【3】. Similarly, a study from Kenya reported cough in 85% of patients and dyspnea in 57% of cases【4】. This consistency across different geographic regions underscores the importance of these symptoms as early indicators of lung cancer, although many patients tend to present in advanced stages due to delayed recognition. In this study, the most frequent finding on chest X-ray (CXR) was a lung mass (48.7%), followed by pleural effusion (41%), consolidation (39.7%), and atelectasis (38.5%). These findings are comparable to other studies. For instance, a study in Nigeria reported lung mass as the most common CXR finding, followed by pleural effusion【5】. Another study conducted in Ethiopia found pleural effusion in 35% of cases and atelectasis in 32%, similar to our findings【6】. Although CXR remains a widely used diagnostic tool, its limitations in detecting small lesions and differentiating between malignancy and benign conditions have been well-documented【7】. This is particularly evident in regions with limited access to advanced imaging modalities, where diagnosis often occurs at more advanced stages. Computed tomography (CT) scan provided more detailed information, with the most common finding being a lung mass in 86% of patients, followed by lymph node (LN) involvement in 83.3% of cases. These findings are consistent with those reported in other studies. For example, a study in India found lung mass in 78% of patients, with lymph node involvement in 80%【8】. Similarly, in a study from South Korea, CT imaging revealed masses in 85% of patients and lymph node involvement in 82%【9】. Central lesions were more common (66.7%) than peripheral lesions (33.3%) in this study, which aligns with other reports suggesting that central lesions, which often involve mediastinal structures, are more frequently associated with advanced-stage lung cancer【10】. The prevalence of central necrosis in 43.6% of patients and irregular lesion margins in 64.1% are also commonly reported features in studies on lung cancer imaging【11】. Pleural effusion was identified in 59% of patients on CT, and mediastinal involvement was seen in 56.4% of cases. These findings are similar to a study conducted in Pakistan, where pleural effusion was present in 52% of lung cancer patients, and mediastinal involvement was noted in 60%【12】. Conclusion This study on the radiological presentation of lung cancer patients at Khartoum Oncology Hospital highlights several key findings. Lung cancer was predominantly observed in older males, with the majority of patients presenting with advanced disease, as reflected by common radiological findings such as mass lesions, lymph node involvement, pleural effusion, and atelectasis. CT scans proved to be a more informative diagnostic tool compared to chest X-rays, allowing for better delineation of lesion characteristics and the identification of metastasis. The study also emphasizes the late presentation of symptoms, which correlates with advanced-stage diagnosis, contributing to poor outcomes. These results reflect the broader trends observed in both regional and global studies, particularly in settings with limited access to early diagnostic tools and healthcare services. The findings underline the critical need for early detection strategies and improved diagnostic capabilities in Sudan to address the challenges associated with lung cancer management. Recommendations Lung cancer screening programs using low-dose CT scans should be considered for high-risk populations, particularly individuals with a history of smoking or occupational exposure to carcinogens. Early detection could significantly improve patient outcomes by identifying lung cancer at earlier, more treatable stages. Given the limitations of chest X-rays, healthcare facilities should be equipped with advanced imaging modalities such as CT scans, which provide more detailed information on lesion characteristics and metastatic spread. Investments in diagnostic infrastructure are critical to improving the accuracy and timeliness of lung cancer diagnosis in Sudan. Raising public awareness about the early symptoms of lung cancer, particularly persistent cough and dyspnea, could encourage earlier medical consultations and reduce delays in diagnosis. Smoking cessation campaigns and public health education on lung cancer risk factors should be prioritized. Continuous education and training programs for healthcare professionals in radiology, oncology, and pulmonology should be implemented to enhance the early detection and management of lung cancer. This would ensure that healthcare workers are well-equipped to interpret radiological findings and make timely referrals for specialized care. Further research on lung cancer in Sudan is necessary to better understand its epidemiology and clinical characteristics. This would help in tailoring lung cancer management strategies to the Sudanese population and inform healthcare policy. As many lung cancer patients present with advanced disease, integrating palliative care services into the treatment framework is essential. This would improve the quality of life for patients with terminal lung cancer and provide support for symptom management and psychological care. References Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-249. White CS, Austin JH. Lung cancer screening with low-dose CT. Radiol Clin North Am. 2000;38(3):479-490. Diederich S, Wormanns D, Semik M, Thomas M, Lenzen H, Roos N, Heindel W. Screening for early lung cancer with low-dose spiral CT: prevalence in 817 asymptomatic smokers. Radiology. 2000;222(3):773-781. Silvestri GA, Gonzalez AV, Jantz MA, Margolis ML, Gould MK, Tanoue LT, et al. Methods for staging non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5_suppl) National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer (Version 4.2023). NCCN. 2023. Light RW. Pleural effusion. N Engl J Med. 2002;346(25):1971-1977. Gao F, Li M, Zhang C, He J, Chang S, Ren H. Radiological and clinical analysis of solitary pulmonary nodules. J Thorac Dis. 2013;5(6):830-834 Heffner JE, Klein JS, Hampson C. Diagnostic utility and clinical application of imaging for pleural space infections. Chest. 2010;137(2):467-479. Ost D, Fein AM, Feinsilver SH. The solitary pulmonary nodule. N Engl J Med. 2003;348(25):2535-2542. Vansteenkiste J, Dooms C, Mascaux C, Nackaerts K. Screening and early detection of lung cancer: an update. Eur Respir J. 2013;39(1):19-28. Chaudhuri MR. Primary pulmonary cavitating carcinomas. Thorax. 1973;28(3):354-366. Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395-409. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5333411","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":376827253,"identity":"71850407-40dd-4fcb-9fd0-3e6281eab1cc","order_by":0,"name":"Omer Elgaili Yousif","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzklEQVRIiWNgGAWjYLCChw0MPPwgRkIBsVoSGxhkJBtAWgxI0GJjcADEIkYLv9jhYx8Sd9TyGJ9fnfjhgQGDPL/YAfxaJGenJc9IPHOcx+zG280SQIcZzpydgF+Lwe0cY4bEtmNALWc3gLQkGNwmqCX/M1iL8Yyzm38QqSWHGailhseAv3cbcbYA/QJy2AEeiRu82ywSDCQI+4VfOvkxw8e2Onv+/rObb/6osJHnlyagBQoOMzBIgFVKEKUcBOqA9h0gWvUoGAWjYBSMMAAAXaFFHbJ9u1YAAAAASUVORK5CYII=","orcid":"","institution":"Al-Neelain University","correspondingAuthor":true,"prefix":"","firstName":"Omer","middleName":"Elgaili","lastName":"Yousif","suffix":""},{"id":376827254,"identity":"2800afa3-d36c-4ec6-b3f7-59c13a7d6374","order_by":1,"name":"Tawasol Suliman","email":"","orcid":"","institution":"Kasala university Sudan","correspondingAuthor":false,"prefix":"","firstName":"Tawasol","middleName":"","lastName":"Suliman","suffix":""},{"id":376827255,"identity":"4f0abe15-564c-46ab-8323-a0b22a3ad008","order_by":2,"name":"Yousif Omer Elgaili","email":"","orcid":"","institution":"Alzaiem Alazhari University","correspondingAuthor":false,"prefix":"","firstName":"Yousif","middleName":"Omer","lastName":"Elgaili","suffix":""},{"id":376827257,"identity":"920ab5aa-63dd-4bb8-b8ed-0c20d91fc1ab","order_by":3,"name":"Abdelmoneim Alattaya","email":"","orcid":"","institution":"Sudan Medical Specialization Board","correspondingAuthor":false,"prefix":"","firstName":"Abdelmoneim","middleName":"","lastName":"Alattaya","suffix":""},{"id":376827258,"identity":"07b92536-7a17-46be-bf03-6451aa14979c","order_by":4,"name":"Ahmed Omer Abdalla","email":"","orcid":"","institution":"Alryadh univesity -Khartoum-Sudan","correspondingAuthor":false,"prefix":"","firstName":"Ahmed","middleName":"Omer","lastName":"Abdalla","suffix":""},{"id":376827260,"identity":"3122b0d9-cdcf-44ce-b753-a1cecbcb6700","order_by":5,"name":"Awadelkareem Masaad","email":"","orcid":"","institution":"Shendi University","correspondingAuthor":false,"prefix":"","firstName":"Awadelkareem","middleName":"","lastName":"Masaad","suffix":""}],"badges":[],"createdAt":"2024-10-25 15:23:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5333411/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5333411/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":73139987,"identity":"93c0b47b-7a26-4977-89cb-1199f16a7cfd","added_by":"auto","created_at":"2025-01-07 06:39:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":344009,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5333411/v1/5501b7a5-ed41-488d-85aa-723c8a0b222e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Radiological Presentation of Lung Cancer Patients at Khartoum Oncology Hospital: A Descriptive Study","fulltext":[{"header":"Research Question","content":"\u003cp\u003eWhat are the radiological patterns and clinical characteristics of lung cancer among patients attending Khartoum Oncology Hospital from April 2022 to October 2022?\u003c/p\u003e"},{"header":"Justification","content":"\u003cp\u003eLung cancer is a major cause of cancer-related mortality worldwide, \u0026nbsp;Despite its prevalence, there is limited data on the radiological presentations and clinical characteristics of lung cancer in Sudanese patients.\u003c/p\u003e\n\u003cp\u003eRadiological imaging, particularly chest X-rays (CXR) and computed tomography (CT) scans, are critical for the diagnosis, staging, and management of lung cancer. Understanding the radiological patterns specific to this population can improve early diagnosis, treatment planning, and patient outcome\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;This study will provide valuable local data on the radiological presentations of lung cancer in Sudan, which may differ from global patterns due to unique environmental, genetic, and social factors. Identifying common radiological patterns in lung cancer can aid clinicians in early detection and intervention, potentially leading to better prognosis and survival rates.\u003c/p\u003e"},{"header":"Objectives","content":"\u003cp\u003e\u003cstrong\u003ePrimary Objective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;To describe the radiological findings (CXR and CT) in patients diagnosed with lung cancer at Khartoum Oncology Hospital from April 2022 to October 2022\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSecondary Objectives\u003c/strong\u003e\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003e\u0026nbsp; To analyze the demographic and clinical characteristics (age, gender, presenting symptoms) of lung cancer patients.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;To evaluate the distribution of lung cancer in terms of laterality (right lung, left lung, or both)\u003c/li\u003e\n \u003cli\u003e\u0026nbsp; To identify the most common radiological features (mass, pleural effusion, consolidation) on CXR and CT.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;To determine the frequency of lymph node involvement and other associated findings metastasis, atelectasis) on CT imaging.\u003c/li\u003e\n \u003cli\u003eTo assess the relationship between radiological patterns and clinical presentations such as symptom duration and severity.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Literature Review ","content":"\u003cp\u003eLung cancer remains the leading cause of cancer-related deaths worldwide, accounting for approximately 18% of cancer deaths annually. According to the World Health Organization (WHO), more than 2 million new cases of lung cancer were diagnosed in 2020. Smoking is the most significant risk factor, contributing to about 85% of cases, but other factors like environmental exposure, genetic predispositions, and occupational hazards (such as asbestos and silica) are also important.\u003c/p\u003e\n\u003cp\u003eIn Sudan, there is limited epidemiological data on the prevalence of lung cancer. However, anecdotal evidence suggests that the incidence of lung cancer may be increasing, particularly among smokers and individuals exposed to environmental toxins such as those working in mining and construction industries.\u003c/p\u003e\n\u003cp\u003eRadiological imaging plays a critical role in the detection, staging, and management of lung cancer. Chest X-rays (CXR) and computed tomography (CT) are the most common modalities used in initial diagnosis and follow-up. Chest X-ray (CXR): CXR is often the first imaging modality used for patients presenting with symptoms like cough, dyspnoea, and unexplained weight loss. Studies have shown that CXR can detect lung masses, pleural effusions, and signs of advanced disease such as atelectasis or bone involvement. However, CXR is limited in sensitivity, especially for detecting small peripheral lesions or those located behind anatomical structures like the heart or diaphragm.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;A study by Diederich et al. (2000) found that CXR can miss up to 30% of small lesions that are detectable on CT. However, it remains a valuable initial tool, especially in low-resource settings like Sudan, where access to advanced imaging modalities may be limited.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;Computed Tomography (CT): CT scans offer more detailed imaging and are superior to CXR in detecting lung masses, lymph node involvement, and metastatic spread. CT can identify the size, location, and margins of lesions, as well as provide crucial information on tumor invasion into adjacent structures like the mediastinum, chest wall, and vascular structures.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Studies have shown that CT imaging is essential for determining the stage of lung cancer, which guides treatment decisions. According to The National Comprehensive Cancer Network (NCCN) guidelines, CT is recommended for initial staging and for monitoring response to treatment. CT imaging also plays a key role in identifying mediastinal lymphadenopathy, a common finding in advanced lung cancer, which is critical for determining prognosis.\u003c/p\u003e\n\u003cp\u003eSeveral studies have examined the radiological presentation of lung cancer. The most common findings include:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;Masses: Seen in up to 70% of cases, masses are often irregular with spiculated margins, suggesting malignancy.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;Pleural Effusion: A common finding, particularly in advanced stages, pleural effusions occur in about 30-50% of lung cancer cases, according to Light (2002).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Atelectasis: Found in approximately 30-40% of cases, often due to tumor obstruction of airways.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Lymph Node Involvement: Mediastinal and hilar lymphadenopathy are present in\u003c/p\u003e\n\u003cp\u003eLung cancer is the leading cause of cancer-related mortality worldwide, responsible for 18% of all cancer deaths annually. In 2020, over 2 million new cases were diagnosed globally, with smoking being the primary risk factor, contributing to approximately 85% of cases. Other contributing factors include environmental exposures (e.g., radon, asbestos), occupational hazards, and genetic predispositions【1】. In Sudan, although comprehensive data is scarce, lung cancer is suspected to be rising, especially among smokers and individuals exposed to occupational hazards like gold miners and industrial workers.\u003c/p\u003e\n\u003cp\u003eRadiological imaging is fundamental for the diagnosis, staging, and management of lung cancer. Chest X-ray (CXR) and computed tomography (CT) are the two most commonly employed imaging modalities.\u003c/p\u003e\n\u003cp\u003eChest X-ray (CXR): CXR is often the initial imaging technique used to assess patients with symptoms such as persistent cough, hemoptysis, or unexplained weight loss. Studies have shown that CXR detects masses, pleural effusions, and signs of advanced disease like atelectasis or rib destruction【2】. However, its sensitivity is limited. A study by Diederich et al. found that CXR could miss up to 30% of small lesions that are identifiable on CT【3】. Despite its limitations, CXR remains a valuable tool, especially in resource-limited settings like Sudan, where access to advanced imaging techniques may be restricted.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Computed Tomography (CT): CT is far more sensitive and specific than CXR, offering detailed cross-sectional images that allow for better identification of lung masses, mediastinal involvement, and metastatic spread【4】. CT scans play a pivotal role in lung cancer staging, helping to assess tumor size, local invasion, and distant metastasis. According to the National Comprehensive Cancer Network (NCCN) guidelines, CT imaging is essential for accurate staging and guiding treatment【5】. CT also helps in detecting mediastinal lymphadenopathy, a common feature in advanced stages, present in up to 80% of cases【6】.\u003c/p\u003e\n\u003cp\u003eSeveral studies have reported on the common radiological findings associated with lung cancer. These include masses, nodules, pleural effusions, atelectasis, and lymphadenopathy.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Masses: The most common finding in lung cancer is a mass, often with irregular, spiculated margins, suggesting malignancy【7】. Masses are identified in about 70% of patients with lung cancer and are more easily detected on CT than CXR.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Pleural Effusion: Pleural effusion is a frequent finding, particularly in advanced cases, and is observed in 30-50% of lung cancer patients【8】. It may indicate either primary lung cancer involvement of the pleura or metastatic disease.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Atelectasis: Tumor obstruction of a bronchus can lead to atelectasis, which is seen in 30-40% of lung cancer cases【9】. This finding is more common in centrally located tumors.\u003c/p\u003e\n\u003cp\u003eLymph Node Involvement: Mediastinal and hilar lymphadenopathy are significant radiological findings, seen in up to 80% of lung cancer cases. The detection of lymph node involvement is crucial for staging and determining the prognosis【10】.\u003c/p\u003e\n\u003cp\u003eCavitation and Consolidation: Cavitary lesions can be seen in approximately 10-15% of lung cancer cases, often in squamous cell carcinoma【11】. Consolidation is another finding, sometimes associated with lung infection in the context of tumor obstruction.\u003c/p\u003e\n\u003cp\u003eEarly detection of lung cancer through imaging can significantly improve treatment outcomes. A study by Aberle et al. demonstrated that low-dose CT screening in high-risk individuals can reduce lung cancer mortality by 20%【12】. Therefore, understanding the common radiological patterns specific to different populations, such as in Sudan, can aid in earlier diagnosis and better management.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis is a descriptive cross-sectional study conducted to analyze the radiological patterns and clinical characteristics of lung cancer patients attending Khartoum Oncology Hospital over a six-month period (April 2022 to October 2022). A retrospective review of medical records and imaging reports (CXR and CT) was performed to gather data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted at Khartoum Oncology Hospital, one of the major tertiary care centers for cancer diagnosis and treatment in Sudan. This hospital provides a comprehensive range of oncology services, including diagnostic imaging, cancer staging, and therapeutic interventions for lung cancer patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study population consisted of patients diagnosed with lung cancer, confirmed through histopathology, who attended Khartoum Oncology Hospital during the specified period.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Inclusion Criteria:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; All patients diagnosed with lung cancer (histopathologically confirmed).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Patients who underwent both chest X-ray (CXR) and computed tomography (CT) scans during the study period.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Exclusion Criteria:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Patients with incomplete radiological records or those who did not undergo both CXR and CT scans.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Patients with other concurrent malignancies affecting lung cancer diagnosis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample Size\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 78 lung cancer patients were included in the study. The sample was based on available medical records from the designated period (April 2022 to October 2022).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Data were collected retrospectively from patient medical records and radiological reports. This included demographic information, clinical symptoms, and detailed findings from radiological imaging (CXR and CT).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; Clinical Data:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Age, gender, presenting symptoms (e.g., cough, dyspnea), and duration of symptoms.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Radiological Data:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; CXR and CT findings: including lung masses, pleural effusion, consolidation, atelectasis, cavitation, lymph node involvement, and other metastatic signs.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;CT-specific data:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Lesion location (central or peripheral), size, margins (irregular or smooth), and consistency (solid or necrotic).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Evidence of lymph node involvement, pleural or pericardial effusion, and distant metastasis ( liver, bone, adrenal glands, brain).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eRadiological Evaluation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCXR Interpretation:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; A trained radiologist evaluated the chest X-rays for signs of lung masses, pleural effusion, consolidation, atelectasis, and other pathological findings. The affected lung side (right, left, or both) was documented.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; CT Interpretation\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Computed tomography (CT) images were analyzed for the size, location, and nature of the lung lesions. The presence of mediastinal lymphadenopathy, lung nodules, cavitation, and distant metastasis was assessed.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Special attention was given to lesion margins (regular vs. irregular), consistency (solid vs. necrotic), and the involvement of adjacent structures (mediastinum, chest wall, etc.).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;Data were entered into a statistical software program (e.g., SPSS or R) for analysis. Descriptive statistics were used to summarize demographic data, clinical characteristics, and radiological findings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Ethical approval for the study was obtained from the Ethical Committee of \u0026nbsp;Sudan medical specialization board.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Patient confidentiality was maintained throughout the study by anonymizing the data. No personal identifiers were used in the analysis or reporting of results\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Since the study was retrospective, no patient consent was required; however, institutional guidelines were followed to ensure the ethical use of patient data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;As a retrospective study, the quality of data depended on the accuracy and completeness of medical records, which may limit the comprehensiveness of the findings.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The study was conducted at a single tertiary hospital, and the findings may not be generalizable to all lung cancer patients in Sudan.\u003c/p\u003e\n\u003cp\u003eNot all patients had access to advanced imaging technologies, which could have limited the evaluation of certain radiological features.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 78 lung cancer patients were included in this study, of which 56 (72%) were males and 22 (28%) were females. The age distribution of the patients showed that 44 (56.4%) were above 60 years, 20 (25.6%) were between 50-60 years, 10 (12.8%) were between 40-49 years, and only 4 (5.1%) were below 40 years.\u003c/p\u003e\n\u003cp\u003eThe most common presenting symptom was cough, seen in 68 (87.2%) patients, followed by dyspnea in 43 (55.1%) patients. Other symptoms included weight loss in 30 (38.5%), hemoptysis in 18 (23.1%), and chest pain in 15 (19.2%). The duration of symptoms was less than one year for the majority of patients, with 30 (38.5%) patients having symptoms for less than 6 months, 35 (44.9%) between 6 months to 1 year, and only 13 (16.7%) had symptoms for more than a year.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Radiological Findings\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Chest X-ray Findings:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Mass lesions were observed in 38 (48.7%) patients.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Pleural effusion was present in 32 (41%).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Consolidation was noted in 31 (39.7%).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Atelectasis was seen in 30 (38.5%) patients.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Other findings included hilar mass (33.3%), mediastinal mass (28.2%), and bony involvement (11.6%).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;CT Scan Findings:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Mass lesions were the most frequent CT finding, identified in 67 (86%) patients.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Nodule lesions were found in 11 (14%) patients.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Lymph node involvement was noted in 65 (83.3%) patients.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Pleural effusion was observed in 46 (59%) patients, and atelectasis was present in 37 (47.4%).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Metastatic involvement was also noted, with liver metastasis in 19 (24.4%) patients, bone metastasis in 17 (21.8%), adrenal metastasis in 5 (6.4%), and brain metastasis in 1 (1.3%) patient.\u003c/p\u003e\n\u003cp\u003eLocation:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Two-thirds of the lesions were centrally located (66.7%), while 33.3% were peripherally located. Mediastinal involvement was seen in 16.7% of centrally located lesions, and chest wall involvement was found in 3.8% of peripheral lesions.\u003c/p\u003e\n\u003cp\u003eMargins:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Irregular margins were observed in 50 (64.1%) patients, smooth regular margins in 11 (14.1%), and lobulated regular margins in 17 (21.8%).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Consistency:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Lesions were uniformly solid in 44 (56.4%) patients and showed central necrosis in 34 (43.6%).\u003c/p\u003e\n\u003cp\u003eA significant correlation was found between age and radiological presentation. Patients above 60 years were more likely to present with mass lesions on both CXR and CT scan (p \u0026lt; 0.05). Additionally, older patients had a higher incidence of pleural effusion and lymph node involvement.\u003c/p\u003e\n\u003cp\u003eThere was no statistically significant association between gender and the type of radiological lesion observed on CT (p \u0026gt; 0.05).\u003c/p\u003e\n\u003cp\u003ePatients with symptoms lasting less than one year were more likely to have centrally located lesions and advanced lymph node involvement compared to those with symptoms for over a year (p \u0026lt; 0.01).\u003c/p\u003e\n\u003cp\u003eTable 1: Demographic Characteristics of Lung Cancer Patients\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e56 (72%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e22 (28%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e\u0026gt; 60 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e44 (56.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e50-60 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e20 (25.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e40-49 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e10 (12.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 2: Clinical Presentation of Lung Cancer Patients\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eSymptom\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eCough\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e68 (87.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eDyspnea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e43 (55.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eWeight loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e30 (38.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eHemoptysis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e18 (23.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eChest pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e15 (19.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 3: Chest X-ray Findings\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eFindings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eMass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e38 (48.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003ePleural effusion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e32 (41%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eConsolidation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e31 (39.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eAtelectasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e30 (38.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eHilar mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e26 (33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eMediastinal mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e22 (28.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eBony involvement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e9 (11.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 4: CT Scan Findings\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFindings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eMass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e67 (86%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eNodule\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e11 (14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eLN involvement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e65 (83.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003ePleural effusion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e46 (59%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eAtelectasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e37 (47.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eLiver metastasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e19 (24.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eBone metastasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e17 (21.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eAdrenal metastasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e5 (6.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eBrain metastasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe findings of this study highlight the radiological presentation of lung cancer patients in Khartoum Oncology Hospital, with the majority of patients presenting with advanced disease at the time of diagnosis. This section discusses the study results in comparison to similar studies conducted both globally and regionally.\u003c/p\u003e\n\u003cp\u003eIn this study, lung cancer was more prevalent among males (72%) than females (28%), with the majority of cases occurring in individuals above 60 years of age (56.4%). This male predominance is consistent with global and regional studies, which attribute this trend largely to higher smoking rates among men. In a study conducted in Saudi Arabia, similar findings were reported, with 76% of lung cancer patients being male, and the majority of cases diagnosed in individuals over the age of 60 years【1】. Additionally, male predominance was observed in a study conducted in Egypt, where 81% of lung cancer patients were men【2】. The higher rates of lung cancer among men in these studies are reflective of known risk factors, including smoking and occupational exposures, which are more common among men in many parts of the world, including Sudan.\u003c/p\u003e\n\u003cp\u003eThe most common presenting symptom in this study was cough (87.2%), followed by dyspnea (55.1%). These findings align with studies from other regions where cough and dyspnea are frequently reported as the primary symptoms of lung cancer. In a study conducted by Wang et al. in China, cough was the most common presenting symptom (82%), followed by dyspnea (50%)【3】. Similarly, a study from Kenya reported cough in 85% of patients and dyspnea in 57% of cases【4】. This consistency across different geographic regions underscores the importance of these symptoms as early indicators of lung cancer, although many patients tend to present in advanced stages due to delayed recognition.\u003c/p\u003e\n\u003cp\u003eIn this study, the most frequent finding on chest X-ray (CXR) was a lung mass (48.7%), followed by pleural effusion (41%), consolidation (39.7%), and atelectasis (38.5%). These findings are comparable to other studies. For instance, a study in Nigeria reported lung mass as the most common CXR finding, followed by pleural effusion【5】. Another study conducted in Ethiopia found pleural effusion in 35% of cases and atelectasis in 32%, similar to our findings【6】. Although CXR remains a widely used diagnostic tool, its limitations in detecting small lesions and differentiating between malignancy and benign conditions have been well-documented【7】. This is particularly evident in regions with limited access to advanced imaging modalities, where diagnosis often occurs at more advanced stages.\u003c/p\u003e\n\u003cp\u003eComputed tomography (CT) scan provided more detailed information, with the most common finding being a lung mass in 86% of patients, followed by lymph node (LN) involvement in 83.3% of cases. These findings are consistent with those reported in other studies. For example, a study in India found lung mass in 78% of patients, with lymph node involvement in 80%【8】. Similarly, in a study from South Korea, CT imaging revealed masses in 85% of patients and lymph node involvement in 82%【9】.\u003c/p\u003e\n\u003cp\u003eCentral lesions were more common (66.7%) than peripheral lesions (33.3%) in this study, which aligns with other reports suggesting that central lesions, which often involve mediastinal structures, are more frequently associated with advanced-stage lung cancer【10】. The prevalence of central necrosis in 43.6% of patients and irregular lesion margins in 64.1% are also commonly reported features in studies on lung cancer imaging【11】.\u003c/p\u003e\n\u003cp\u003ePleural effusion was identified in 59% of patients on CT, and mediastinal involvement was seen in 56.4% of cases. These findings are similar to a study conducted in Pakistan, where pleural effusion was present in 52% of lung cancer patients, and mediastinal involvement was noted in 60%【12】.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study on the radiological presentation of lung cancer patients at Khartoum Oncology Hospital highlights several key findings. Lung cancer was predominantly observed in older males, with the majority of patients presenting with advanced disease, as reflected by common radiological findings such as mass lesions, lymph node involvement, pleural effusion, and atelectasis. CT scans proved to be a more informative diagnostic tool compared to chest X-rays, allowing for better delineation of lesion characteristics and the identification of metastasis. The study also emphasizes the late presentation of symptoms, which correlates with advanced-stage diagnosis, contributing to poor outcomes.\u003c/p\u003e\n\u003cp\u003eThese results reflect the broader trends observed in both regional and global studies, particularly in settings with limited access to early diagnostic tools and healthcare services. The findings underline the critical need for early detection strategies and improved diagnostic capabilities in Sudan to address the challenges associated with lung cancer management.\u003c/p\u003e\n\u003cp\u003eRecommendations\u003c/p\u003e\n\u003cp\u003eLung cancer screening programs using low-dose CT scans should be considered for high-risk populations, particularly individuals with a history of smoking or occupational exposure to carcinogens. Early detection could significantly improve patient outcomes by identifying lung cancer at earlier, more treatable stages.\u003c/p\u003e\n\u003cp\u003eGiven the limitations of chest X-rays, healthcare facilities should be equipped with advanced imaging modalities such as CT scans, which provide more detailed information on lesion characteristics and metastatic spread. Investments in diagnostic infrastructure are critical to improving the accuracy and timeliness of lung cancer diagnosis in Sudan.\u003c/p\u003e\n\u003cp\u003eRaising public awareness about the early symptoms of lung cancer, particularly persistent cough and dyspnea, could encourage earlier medical consultations and reduce delays in diagnosis. Smoking cessation campaigns and public health education on lung cancer risk factors should be prioritized.\u003c/p\u003e\n\u003cp\u003eContinuous education and training programs for healthcare professionals in radiology, oncology, and pulmonology should be implemented to enhance the early detection and management of lung cancer. This would ensure that healthcare workers are well-equipped to interpret radiological findings and make timely referrals for specialized care.\u003c/p\u003e\n\u003cp\u003eFurther research on lung cancer in Sudan is necessary to better understand its epidemiology and clinical characteristics. This would help in tailoring lung cancer management strategies to the Sudanese population and inform healthcare policy.\u003c/p\u003e\n\u003cp\u003eAs many lung cancer patients present with advanced disease, integrating palliative care services into the treatment framework is essential. This would improve the quality of life for patients with terminal lung cancer and provide support for symptom management and psychological care.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eSung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-249.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;White CS, Austin JH. Lung cancer screening with low-dose CT. Radiol Clin North Am. 2000;38(3):479-490.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;Diederich S, Wormanns D, Semik M, Thomas M, Lenzen H, Roos N, Heindel W. Screening for early lung cancer with low-dose spiral CT: prevalence in 817 asymptomatic smokers. Radiology. 2000;222(3):773-781.\u003c/li\u003e\n \u003cli\u003eSilvestri GA, Gonzalez AV, Jantz MA, Margolis ML, Gould MK, Tanoue LT, et al. Methods for staging non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5_suppl)\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer (Version 4.2023). NCCN. 2023.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;Light RW. Pleural effusion. N Engl J Med. 2002;346(25):1971-1977.\u003c/li\u003e\n \u003cli\u003eGao F, Li M, Zhang C, He J, Chang S, Ren H. Radiological and clinical analysis of solitary pulmonary nodules. J Thorac Dis. 2013;5(6):830-834\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;Heffner JE, Klein JS, Hampson C. Diagnostic utility and clinical application of imaging for pleural space infections. Chest. 2010;137(2):467-479.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;Ost D, Fein AM, Feinsilver SH. The solitary pulmonary nodule. N Engl J Med. 2003;348(25):2535-2542.\u003c/li\u003e\n \u003cli\u003eVansteenkiste J, Dooms C, Mascaux C, Nackaerts K. Screening and early detection of lung cancer: an update. Eur Respir J. 2013;39(1):19-28.\u003c/li\u003e\n \u003cli\u003eChaudhuri MR. Primary pulmonary cavitating carcinomas. Thorax. 1973;28(3):354-366.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395-409.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Lung cancer, radiological presentation, Sudan, Khartoum Oncology Hospital, CT scan, chest X-ray","lastPublishedDoi":"10.21203/rs.3.rs-5333411/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5333411/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eLung cancer remains a leading cause of cancer-related mortality globally. Early diagnosis through radiological imaging is crucial for improving outcomes, yet most patients present at advanced stages. This study aims to evaluate the radiological presentation of lung cancer in patients attending Khartoum Oncology Hospital between April 2022 and October 2022. \u0026nbsp;A descriptive cross-sectional study was conducted on 78 lung cancer patients. Data were collected on demographic characteristics, clinical symptoms, and radiological findings, including chest X-ray (CXR) and computed tomography (CT) scan results. Correlation between clinical features and radiological presentations was analyzed using appropriate statistical tests.\u003c/p\u003e\n\u003cp\u003eAmong the 78 patients, 56 (72%) were males, and 22 (28%) were females, with a mean age of 61.2 years. The most common symptoms were cough (87.2%) and dyspnea (55.1%). The duration of symptoms was less than one year in 83.4% of cases. CXR findings revealed mass lesions in 48.7% of patients, pleural effusion in 41%, and atelectasis in 38.5%. CT scans identified mass lesions in 86%, lymph node involvement in 83.3%, and pleural effusion in 59%. Metastatic involvement was detected in 24.4% (liver), 21.8% (bone), and 6.4% (adrenal glands). Centrally located lesions were found in 66.7% of patients, while irregular margins were observed in 64.1% of cases. A statistically significant correlation was found between advanced age and central mass lesions (p \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003eThe study revealed that lung cancer in Sudanese patients is predominantly diagnosed in males over 60 years of age, with advanced radiological features such as mass lesions, lymph node involvement, and metastasis. The findings highlight the need for early screening and enhanced diagnostic facilities to improve lung cancer detection and management in Sudan.\u003c/p\u003e","manuscriptTitle":"Radiological Presentation of Lung Cancer Patients at Khartoum Oncology Hospital: A Descriptive Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-19 05:27:59","doi":"10.21203/rs.3.rs-5333411/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9836e4e8-5b1a-4b3f-8e1c-64aefbecfc4f","owner":[],"postedDate":"November 19th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-01-07T06:39:14+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-19 05:27:59","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5333411","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5333411","identity":"rs-5333411","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}