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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Magnetic resonance imaging and computed tomography were compared in a prospective study of 137 lung cancer patients proved by surgery or autopsy for determining the staging, evaluation of therapeutic effect and diagnosis of recurrent tumor. 1. Lung cancer staging In peripheral lung cancer, T1 and T2 relaxation times of the tumors before operation have some correlation with those of operated specimens. These relaxation times, however, are of limited nodule characterization. Hilar mass and adjacent pulmonary consolidation (obstructive pneumonia or collapse) can be distinguished on T2-weighted image (77%) and Gd-DTPA enhanced image (80%). Therefore these images help in distinguishing tumor from peripheral lung disease. In the diagnosis of tumor invasion to the heart and great vessels, MRI is superior to CT because MRI can be helpful in distinguishing true mass from heart and great vessels. As for the chest wall, MRI is more useful than CT in detecting tumor invasion especially to the thoracic inlet and superior regions. In the diagnosis of mediastinal and hilar lymphadenopathy, MRI is equivalent or slightly inferior to CT, but MRI can easily demonstrate the lymphadenopathy at subcarinal region on coronal image. 2. Evaluation of therapeutic effect in lung cancer patients treated by radiation and chemotherapy MRI patterns of therapeutic effect was divided into 3 types. It is suggested that there is some correlation between these patterns and histologic types. MRI can easily demonstrate necrotic area on T2-weighted and Gd-DTPA enhanced images. 3. Diagnosis of recurrent tumor in treated lung cancer Concerning detecting recurrent tumor after surgery or irradiation, and delineating tumor from radiation pneumonitis, T2-weighted and Gd-DTPA enhanced images are of clinical value.
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PMID:[MR imaging in the assessment of lung cancer patients: primary lung cancer staging, evaluation of therapeutic effect and diagnosis of recurrent tumor]. 279 69

65 patients suspected of having intrathoracic masses were studied using magnetic resonance imaging (MRI) and computed tomography (CT). The intensity difference between mass and adjacent normal tissue or mediastinal fat was greater on MRI than on CT images. MRI was superior to CT in differentiating bronchogenic carcinomatous tumours from postobstructive pneumonia and/or lobar collapse. MRI images most clearly depicted obstructed mediastinal vessels and were also able to indicate intravenous flow reductions. The latter could be demonstrated by an increase of signal intensity within venous structures proximal to the obstruction. In patients with lung cancer no significant differences were found between the two imaging methods for the evaluation of tumour extent or node involvement.
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PMID:[Magnetic resonance tomography of intrathoracic tumors]. 282 81

Total cancer deaths were not increased among 2,074 women and 1,277 men who were fluoroscopically examined an average of 73 and 91 times, respectively, during lung-collapse therapy for tuberculosis (TB). Patients who did not receive this form of therapy (2,141 women and 1,418 men) and general population rates were used for comparison. All subjects were discharged alive from eight TB sanatoria in Massachusetts between 1930 and 1954; the average follow-up was 23 years. Deaths due to breast cancer were not increased among exposed females [standardized mortality ratio (SMR) = 1.0, n = 24], and SMRs greater than 2.1 could be excluded with 95% confidence. In contrast to other series, our inability to detect a breast cancer excess was likely due to lower breast doses (66 rad) and higher average ages at exposure (28 yr) and thus lower sensitivity. A deficit of lung cancer among exposed males and females was observed (SMR = 0.8, n = 26), even though increased risks have been observed among other populations exposed to similar dose levels. The estimated average lung dose was 91 rad, and SMRs greater than 1.2 for lung cancer could be excluded with 95% confidence. Overall, this study indicates that the radiation hazard of multiple low-dose exposures experienced over many years is not greater than currently accepted estimates for breast and lung cancer. For lung cancer the radiogenic risk may be less than predicted from high-dose, single-exposure studies.
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PMID:Cancer mortality after multiple fluoroscopic examinations of the chest. 310 47

The ability of magnetic resonance imaging (MRI) to detect T-factor was compared with that of computed tomography (CT) in 52 patients with primary lung cancer proven by surgery or autopsy, and the results were analyzed in relation to the operative and pathologic findings. In the diagnosis of tumor invasion of the heart and great vessels, MRI provided information as accurate as CT. The T1-weighted images in particular were of considerable value in separating the tumor from the mediastinal and hilar fat. Tumor extent in accompanying peripheral obstructive pneumonia or collapse was demarcated in 21% of the cases studied by CT and in 33% to 53% by MRI. On the other hand, the T2-weighted images obtained with longer echo time (TE) were useful in distinguishing the tumor from secondary changes.
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PMID:Detection of T-factor in lung cancer using magnetic resonance imaging and computed tomography. 336 28

Primary lung cancer is divided into two types: peripheral type and hilar or central type. Peripheral lung cancer appears as a solitary mass or patchy shadow and is typically lobulated or irregular in shape. Any regular or scattered calcification within or around the lesion on routine radiographs indicates that it is benign. Hilar or central lung cancer may accompany hilar and mediastinal lymphadenopathy, lobar collapse and consolidation, and pneumonitis distal to a mass in a large bronchus. In addition, it is very important that the metastases of the hilar and mediastinal lymph nodes are detected preoperatively or prior to conservative therapy. On 44 cases of lung cancer pathologically proved, the diagnostic accuracy of the metastases of the hilar or mediastinal lymph nodes is 42.4% preoperatively on routine radiographs.
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PMID:[Radiographic diagnosis of lung cancer and lymph nodal metastasis of the mediastinum]. 630 91

In April 1988 the Christie Hospital started using the microSelectron-HDR machine to deliver intraluminal radiotherapy (ILT) to inoperable bronchial carcinomas causing symptoms due to endobronchial disease. Results of treatment in the first 406 patients with primary non-small-cell carcinoma are presented. Three main categories of patient were defined. Category 1 consisted of 324 patients (79.8%) who were previously unirradiated and received a single fraction of ILT as their primary treatment, mostly to a dose of 1500 cGy (76%) or 2000 cGy (23%) at 1 cm from the centre of the iridium-192 treatment source. The percentage of these patients whose symptoms or signs were improved at 6 weeks following ILT were as follows: stridor 92%, haemoptysis 88%, cough 62%, dyspnoea, 60%, pain, 50% and pulmonary collapse, 46%. Approximately two-thirds of these patients (67.3%) derived long lasting palliation and required no further treatment during their lifetime. The other third of patients needed subsequent treatment at some stage because of recurrence of their symptoms and in this situation external beam radiotherapy (EB) or a repeat ILT treatment was effectively utilised. Category 2 consisted of 65 patients (16%) who had previously received EB but required ILT when their tumour recurred. At 6 weeks post-ILT levels of symptom palliation were broadly similar to those obtained if ILT was used in previously unirradiated individuals, although the improvement was not so well sustained with time and only 7% showed improvement in pulmonary collapse at 6 weeks. Category 3 consisted of 17 patients (4.2%) in whom ILT was used concurrently with EB as a combined initial treatment. Similar levels of palliation were seen when compared with patients who received a single ILT treatment only. Overall, ILT was well tolerated in terms of early and late morbidity. In conclusion, the efficiency of a single ILT treatment in palliating symptoms due to endobronchial tumour in previously unirradiated individuals is comparable with that reported in series where treatment for advanced lung cancer combines a prolonged course of EB concurrently with several ILT treatments.
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PMID:High dose rate intraluminal radiotherapy for carcinoma of the bronchus: outcome of treatment of 406 patients. 753 4

Two-dimensional Doppler echocardiography was used as an intraoperative cardiac function monitor in anesthetic management of a 79-year-old male with hypertrophic obstructive cardiomyopathy (HOCM) who underwent pulmonary lobectomy for lung cancer. Circulatory collapse occurred after thoracic epidural anesthesia (TEA), and was aggravated with following induction of general anesthesia. The collapse did not improve with phenylephrine nor atropine and necessitated ethylephrine and dopamine. During the above course, left ventricular outflow tract pressure gradient measured with continuous wave Doppler method was almost in proportion to cardiac output measured with thermo-dilution method. This means that TEA and the administration of inotropics did not worsen the left ventricular outflow tract obstruction. Left ventricular filling property estimated by trans-mitral flow velocity spectra improved when hemodynamics was stabilized with continuous infusion of dopamine, while it had been impaired during preoperative period and at the beginning of anesthesia. Our observation suggests that TEA for HOCM patient is a relative indication because it may exert negative inotropic effect, and that careful titration with inotropics is not contraindicated when undesired cardiac depression is proved by echocardiography.
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PMID:[Echocardiographic observation of intraoperative circulatory collapse in a patient with hypertrophic obstructive cardiomyopathy]. 830 35

In this report the usefulness of Tl-201 SPECT and modified retention images in the differentiation of lung cancer and postobstructive collapse was studied. Two-phase Tl-201 SPECT was performed in 20 lung cancer lesions in which postobstructive collapse was suspected on CT. Retention imaging was done afterward. Three types of Tl-201 images were compared with the bolus CT images. Bolus CT differentiated lung cancer from postobstructive collapse in 7 of the 20 lesions (35%). Tl-201 SPECT differentiated the two conditions in 9 of 20 lesions (45%) on early Tl-201 SPECT and in 13 of 20 lesions (65%) on delayed imaging. With modified retention images, differentiation was possible in 13 of 20 lesions (65%). By combining delayed Tl-201 SPECT and modified retention images, lung cancer alone could be demonstrated in 18 of 20 lesions (90%). Combined delayed Tl-201 SPECT and modified retention images were more effective than bolus CT in delineating the extent of lung cancer in the presence of postobstructive collapse.
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PMID:Diagnosis of lung cancer using two-phase Tl-201 SPECT and modified retention image to view tumor in the collapsed lung: comparison with bolus CT. 979 39

Video-assisted thoracoscopy using a miniaturized endoscope (mini-VAT) was applied for preoperative diagnosis in general thoracic surgery. Thirty-one patients, including 27 with indeterminate pulmonary nodule and 4 with suspected pleural involvement of lung cancer or metastatic pleural tumor, underwent mini-VAT. As a pilot study, 14 of the former 27 patients underwent mini-VAT while receiving general anesthesia. As a prospective study, all the remaining 17 patients underwent mini-VAT while receiving local anesthesia. Solid scopes of three different sizes, 0.9, 1.9, or 4.0 mm diameter, were used. An artificial pneumothorax for scope introduction was produced by needle thoracentesis under atmospheric pressure. Automatic cutting needle biopsy was used for tissue sampling. In the pilot study group, mini-VAT with a 4.0-mm scope provided excellent visibility and diagnostic sensitivity of 100%. This study group showed the diagnostic sensitivity of needle biopsy for pulmonary nodule to be 100%. Hemorrhages and air leaks at biopsy sites were sealed with blood coagulation in a short time. In the prospective study group, mini-VAT with a 4.0-mm scope with the patients receiving local anesthesia provided a diagnostic sensitivity of 91% for pulmonary nodule and a diagnostic accuracy of 100% for suspected pleural involvement. Causes of failure of mini-VAT with the use of local anesthesia were cough reflex during needle biopsy and incomplete lung collapse for deeply located target in two cases. The adverse effects of the mini-VAT were paradoxical respiration in two cases in which local anesthesia was used. The patients who received only local anesthesia required no chest tube drainage. Mini-VAT is a simple, minimally invasive procedure suitable as a preoperative examination technique for histologic diagnosis, evaluation of disease progression, and selection of strategy in thoracic surgery.
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PMID:Preoperative diagnosis with video-assisted thoracoscopy with miniaturized endoscopes in general thoracic surgery: a preliminary study. 987 11

The aim of this study was to clarify the thin-section CT features of small peripheral carcinomas of the lung on the basis of pathologic findings of tumor growth patterns. Thin-section CT and pathologic correlation was evaluated in 19 patients with surgically verified small peripheral carcinomas of the lung ( < 20 mm in size) that had been detected in a screening trial for lung cancer using spiral CT. Four thin-section CT types of nodules were observed: (a) type L1 (4 of 19, 21 %), a fairly well-defined nodule with ground-glass attenuation, corresponding to tumor lepidic growth without alveolar collapse; (b) type L2 (4 of 19, 21 %), a partly lobulated nodule with a low but inhomogeneous attenuation, corresponding to tumor lepidic growth with scattered foci of alveolar collapse; (c) type L3 (4 of 19, 21 %), an ill-defined nodule with an irregularly shaped higher-density central zone in a ground-glass attenuation peripheral zone, accompanied by convergence of the bronchovascular structures from the surrounding lung parenchyma, which corresponded to desmoplastic response in the central zone and to tumor lepidic growth in the peripheral zone; and (d) type H (7 of 19, 37 %), a well-defined nodule with a solid homogeneous attenuation, corresponding to tumor hilic growth. Thin-section CT features of small peripheral carcinomas of the lung can be classified into four types, based on the density distribution of the tumor, which reflect the histologic findings.
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PMID:Small peripheral carcinomas of the lung: thin-section CT and pathologic correlation. 1060 57


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