Comparison of computed tomography and radionuclide scanning for detection of brain metastases in small cell lung cancer
Neurologic history and examination, radionuclide brain scans (RN), and computed tomographic brain scans (CT) were performed at diagnosis and sequentially in 153 consecutive patients with small cell lung cancer (SCLC) to assess the sensitivity and accuracy of these screening methods and to determine whether the early detection of brain metastases influences survival. CT scans (sensitivity, 98%; positive predictive accuracy, 98%) were superior to RN scans (sensitivity, 71%; positive predictive accuracy, 86%) in patients with or without neurologic signs or symptoms. However, CT scans were positive in only 6% of asymptomatic patients at diagnosis and 13% of asymptomatic patients after systemic therapy. Brain metastases detected by CT scan were the sole site of extensive-stage disease in 6% of patients at diagnosis. Despite the enhanced ability of CT scans to detect asymptomatic lesions, survival after therapeutic cranial irradiation was similar for asymptomatic and symptomatic patients. The results suggest that CT brain scans should be used routinely in SCLC patients with neurologic signs or symptoms, at diagnosis (when treatment decisions are based on stage), and at six-month intervals in patients with prior brain metastases and in whom erratic follow-up is likely.
- Research Organization:
- NCI-Navy Medical Oncology Branch, Bethesda, MD
- OSTI ID:
- 6304301
- Journal Information:
- J. Clin. Oncol.; (United States), Journal Name: J. Clin. Oncol.; (United States) Vol. 2:9; ISSN JCOND
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
62 RADIOLOGY AND NUCLEAR MEDICINE
ACCURACY
BODY
BRAIN
CARCINOMAS
CENTRAL NERVOUS SYSTEM
COMPARATIVE EVALUATIONS
COMPUTERIZED TOMOGRAPHY
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
LUNGS
METASTASES
NEOPLASMS
NERVOUS SYSTEM
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RESPIRATORY SYSTEM
TOMOGRAPHY