Planar cobalt-57 bleomycin scintigraphy compared with CT-scan in the diagnosis and staging of lung cancer.
OBJECTIVE
Cobalt-57 bleomycin accumulates in tumour cells and is a diagnostic aid for discriminating malignant and benign lesions. Published data indicate that planar cobalt-57 bleomycin scintigraphy (bleo-scan) is a sensitive and specific test in the diagnosis and staging of lung cancer. CT-scan was however not used in these studies. We tested the value of bleo-scan and compared the results with those of computed tomography (CT-scan).


METHODS
Bleo-scan and CT-scan were obtained from patients who were consecutively investigated because of a suspicious lesion on their chest X-ray.


RESULTS
In 59 patients carcinoma of the lung was diagnosed 49 times (83%). The sensitivity of bleo-scan was 90%, specificity was 30% and positive predictive value (PPV) 86%. CT-scan could not discriminate between malignant and benign lesions. Thirty-two of the 41 patients with non-small-cell lung cancer had pathological examination of mediastinal lymph nodes, revealing metastases in 47% of the patients. Bleo-scan and CT-scan, respectively, had a sensitivity of 53 and 87%, a specificity of 77 and 82%, and negative predictive values (NPV) of 65 and 87%. In the 49 lung cancer patients distant metastases were detected at 11 sites in 10 patients. Bleo-scan gave false-negative and false-positive results.


CONCLUSIONS
Bleo-scan in (suspected) lung cancer adds too little to the diagnostic procedure to make it a routine procedure. CT-scan gives indispensable information about possible mediastinal involvement.
Verhoeven
G T
GT
Department of Pulmonary Medicine, University Hospital Dijkzigt, Rotterdam, Netherlands.
Kho
G S
GS
Ausema
L
L
Krenning
E P
EP
Hilvering
C
C
D001761:Bleomycin; D003037:Cobalt Radioisotopes; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D003037:Cobalt Radioisotopes; D001761:Bleomycin