RADIOISOTOPE SCANNING IN INITIAL STAGING OF BRONCHOGENIC CARCINOMA

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Abstract
The use of routine radioisotope scanning to screen for subclinical metastatic disease in the initial staging of bronchogenic carcinoma was studied. To define the value of scans, liver, brain and bone scans were studied prospectively in 111 patients and retrospectively in 114 patients. Among patients with clinical findings suggesting metastatic disease, 14.4% of the liver scans, 12.3% of the brain scans, and 35.7% of the bone scans were positive. All patients free of clinical findings had negative liver and brain scans. Positive bone scans occurred in 8% of the patients without clinical abnormalities. True-positive bone scans occurred in less than 4% the patients free of clinical abnormalities. The clinical findings noted in the patients pointed to the organ involved in only 76% of the abnormal liver scans, 62% of the abnormal brain scans, and 75% of the abnormal bone scans. Clinical findings associated with positive liver and brain scans were multiple and significant, whereas findings with the positive bone scans could be few or subtle. Routine scanning failed to identify a significant number of patients with clinically unsuspected metastatic disease. Liver, brain and bone scanning is indicated only in patients suspected of having metastatic disease.

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