Computerized axial tomography in the pretreatment assessment of small-cell carcinoma of the bronchus

Abstract

Computerized axial tomographic scans (CAT scans) of thorax and abdomen were used as part of the initial staging procedure of 50 consecutive patients with small-cell bronchogenic carcinoma (SCBC). The aims were to define the extent of the primary tumor and metastatic spread, and to compare the information obtained from CAT scans with conventional staging procedures. With CAT scanning, spread of the primary tumor was found to be far more extensive than originally believed when defined by conventional assessment. Of 35 patients conventionally staged as localized T1 or T2 tumors, 27 (77%) had their stage increased to extensive T3 disease. similarly, subcarinal lymph nodes were found in one patient when conventional methods were used (2%), but 16 patients (32%) were found when CAT scan was used. Unsuspected adrenal metastases were found in eight patients (16%) and retrocrural nodes in four patients (8%). Thirty-seven patients (74%) were found to have Stage III tumors when conventional staging was used; 47 patients (94%) were found to be Stage III following CAT scanning, demonstrating that, within the thorax, localized tumors are very uncommon. CAT scanning demonstrates the degree of intrathoracic spread very clearly, and has a valuable role in the initial investigation of patients with SCBC if the planned treatment includes radiotherapy.

Metastatic Carcinomas of the Adrenal Glands: From Diagnosis to Treatment

“…Aspiration cytology under CT or ultrasound guidance can be regarded as the procedure of choice in the diagnostic evaluation of adrenals in patients with malignant neoplasms, as long as the cytologic findings are correlated with the clinical and laboratory data (45). For instance, concerning secondary adrenal carcinomas from small and non-small cell carcinoma of the bronchus, CT guided preoperative evaluation is of paramount importance (46)(47)(48)(49)(50). The results of all relevant studies are shown in Table I.…”

Repeated Computed Tomography during Treatment of Small Cell Carcinoma of the Lung

“…(7) found that repeated CT examinations are of value for defining complete remission, and that CT assessment of tumor volume in patients with limited disease correlates closely with survival. They also claimed that CT had a valuable role in the initial examination of patients with SCCL if the treatment plan includes XRT.…”

“…Previous investigations have suggested computed tomography of the thorax and abdomen for staging of patients with SCCL to be of little value due to the frequent dissemination of the tumor and the limited choice of treatment modalities (7,9,12,15,21). The present investigation evaluates the use of repeated computed tomography in comparison with chest radiography during the course of the treatment.…”