Cobalt-57 bleomycin scanning for lung cancer detection: a prospective study in thoracic surgery.
Patients displaying an abnormal chest X-ray, in some cases, cause a difficult diagnostic problem. A differential diagnosis between benign and malignant lesions is important to determine the choice of treatment i.e. whether or not to perform a thoracotomy. In a prospective study, we have examined the role of 57Co-bleomycin scanning for prethoracotomy assessment of 60 patients with a high clinical probability of lung cancer. For these patients, a sensitivity of 89%, a specificity of 84% and an accuracy of 88% were found. However, as a consequence of the six false-negative scans (two in-situ carcinomas and four stage I carcinomas), bleomycin scanning cannot be regarded as adequate for obviating thoracotomy in patients with a high clinical probability of lung cancer but a negative scan. Nevertheless, the technique is useful for the assessment of tumour size and for the detection of hilar, mediastinal and extra-thoracic metastases, with consequences for TNM staging. It has been found that the tumour dimension correlates well with the actual anatomo-pathologic size determined after surgical examination (r2 = 0.65 and p less than 0.01). Therefore, with an accuracy around 90% for the diagnosis of lung cancer, 57Co-bleomycin scanning offers a major tool for use in clinical investigation.
D
D
Slosman
B
B
Polla
R
R
Egeli
D
D
Townsend
C
C
Signorelli
R
R
Megevand
A
A
Donath
D000230:Adenocarcinoma / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D001761:Bleomycin; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D003037:Cobalt Radioisotopes; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011300:Preoperative Care; D011336:Probability; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012907:Smoking
D003037:Cobalt Radioisotopes; D001761:Bleomycin