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

Apical lung cancers account for about 5% of pulmonary lesions and can be divided into two groups: Pancoast and non-Pancoast lesions. Recently, the use of MRI has been suggested in combination with CT to stage this kind of lung cancer. In this paper the authors' experience is reported relative to the current role of MRI and CT in the staging of apical lung cancers. Twelve male patients (mean age: 60.5 years) with apical lung cancers underwent conventional X-ray, CT and MR examinations of the chest. CT and MR images were studied by two independent radiologists with specific experience; surgery was the gold standard in three patients and MR and clinical symptoms in the patients not referred for surgery. In 15/108 cases (13.8%) CT and MR findings were in disagreement but in 93/108 cases (86.2%) they were in agreement. The highest disagreement rate was observed in the study of apical chest wall infiltration (33.3%), while in the study of anonymous vein involvement CT and MRI were always in agreement. The correct assessment of the regional extent of apical lung cancers is mandatory for treatment planning. In this kind of tumors MRI can be considered the method of choice thanks to its high contrast resolution and multiplanar imaging capabilities.
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PMID:[Staging of pulmonary apex tumors. Computerized tomography versus magnetic resonance]. 806 51

Three-dimensional CT images of six inflated lung specimens (4 lung cancer, 1 bronchiectasis, 1 hamartoma) were reconstructed from contiguous serial sections to study some probable problems in the clinical application of the technique. Optimal thickness and space of sections were evaluated, and contiguous 1.5-mm serial sections were found to provide a clear 3-D image with high fidelity. It was difficult to set a proper threshold to create clear images because a wide CT window is inconsistent with low noise. The images of tubular and linear structures such as from bronchi and vessels demonstrated higher resolution when reconstructed from scanning in the more perpendicular cross-sectional direction to their axis. Although 3-D images obtained here were not as clear as expected, technological advances such as helical CT or MRI may provide 3-D images with sufficient resolution to be applied clinically.
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PMID:[Three-dimensional CT images of the lung--preliminary study using inflated lung specimens]. 823 Aug 87

Ten patients with meningeal carcinomatosis associated with nonhaematological neoplasms were examined: six with breast, two with gastrointestinal and one with lung cancer, plus one with a tumour of unknown origin. Cytology was positive in all but one. The patients were classified into four groups according to the gadolinium-enhanced MRI (Gd-MRI) appearances: group 1 had pure leptomeningeal carcinomatosis, group 2 dural carcinomatosis, group 3 spinal leptomeningeal carcinomatosis, and group 4 had normal Gd-MRI except for hydrocephalus. In group 1, Gd-MRI showed diffuse enhancement of the subarachnoid space, including the cisterns around the midbrain, the sylvian fissures, or cerebellar and cerebral sulci. In group 2, Gd-MRI showed diffuse, thick, partially nodular enhancement of the dura mater. No leptomeningeal or subependymal enhancement was evident. In group 3, nodular masses were seen only in the spinal canal. In group 4, no definite evidence of meningeal carcinomatosis was demonstrated on contrast-enhanced CT (CE-CT) or Gd-MRI. The median survival time was 2.0 months in group 1, 1.0 month in group 3, and 4.5 months in group 4, but the two patients in group 2 were alive 10 and 15 months after a definite diagnosis of meningeal carcinomatosis was made. In all patients examined by both CE-CT and Gd-MRI, the latter was superior for identification of meningeal carcinomatosis. Hydrocephalus in an important indirect sign of leptomeningeal carcinomatosis, but was not seen in patients with dural carcinomatosis despite the presence of increased intracranial pressure.
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PMID:Correlation of MRI and clinical features in meningeal carcinomatosis. 823 77

Influence of MR-imaging on definition of treatment volume was studied prospectively in 43 patients undergoing radiotherapy for mediastinal malignancy (twelve Morbus Hodgkin, four non-Hodgkin-lymphoma, 26 lung cancer, one nephroblastoma). Conventional treatment planning using a simulator and all available information from axial CT-scanning and posterior-anterior and lateral radiographs was compared to a MRI-assisted procedure. Contours from coronary MR-sections acquired in treatment position were superposed onto the simulator radiograph using a subtrascope (MRI-simulation). MR-imaging using T1-weighted sequences resulted in excellent delineation of tumor masses from mediastinal fat, airways and vascular structures. The high soft tissue contrast allowed an exact and reproducible transfer of tumor contours onto the simulator radiograph. This led to changes in field configuration in 11/43 patients concerning mainly tumor extension infracarinally and in the caudal parts of the lung hili. Superiority of MRI-assisted simulation was noted as usefulness of axial CT-scanning to delineate margins was compromised in these areas by partial volume effects of tangentially represented structures and suboptimal contrasted vascular spaces.
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PMID:Integration of coronal magnetic resonance imaging (MRI) into radiation treatment planning of mediastinal tumors. 839 Nov 72

We successfully treated surgically using cardiopulmonary bypass an elderly patient, a seventy-six-year-old man, with primary advanced lung cancer (rt. S6) with left atrial extension. He had intermittent episodes of bloody sputum. A preoperative chest roentogenogram revealed an abnormal mass shadow in S6 of the right lower lobe of the lung. MRI findings of the chest and a right heart catheterization with levophase demonstrated the extension of the tumor into the left atrium. A distant metastatic work-up was negative. By use of the full lateral thoracotomy and cardiopulmonary bypass, the tumor was removed en bloc through a combined left atrial resection and right middle and lower lobectomy. The patient has been well without and symptoms 8 months after surgery. An advanced lung cancer invading the left atrium can be safety and completely resected with the use of cardiopulmonary bypass if the extent of left atrial involvement is recognized preoperatively.
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PMID:[The combined resection of left atrium for advanced lung cancer on cardiopulmonary bypass: a case report]. 874 54

1H MR spectroscopy was used to correlate the metabolite signals in 66 untreated metastatic brain tumors with the results of Gd-DTPA enhanced MRI. Cubic volumes containing brain metastases of lung cancer (n = 17), mammary carcinoma (n = 24), melanoma (n = 12) and those originating from other tumors (n = 13) were examined using the double spin echo technique with CHESS pulses for water suppression and TE = 135 ms. Apart from trends toward reduced signals of choline-containing compounds (Cho) and reduced post-Gd MRI contrast in lung cancer compared with the other pathology groups, the four tumor groups had similar MRI and MRS characteristics. Metastases without lipid or lactate (Lact) signal in the 1H MR spectra were comparatively small in size with homogeneous post-Gd MRI enhancement (33 +/- 5%, means +/- SEM; n = 24) and elevated Cho signals compared with normal contralateral brain tissue (70 +/- 5% of contralateral N-acetyl aspartate signal; p < 0.001). The other metastases showed either unambiguous lipid signals (n = 30) or MRS detectable Lact (n = 12) and were heterogeneous on MRI with divergent signals of Gd-enhancement (49 +/- 5% vs 14 +/- 8%, p < 0.001) and Cho (88 +/- 10 vs 47 +/- 8% of contralateral NAA; p = 0.02). Those with Lact were significantly larger compared with both other groups (p < 0.02, both). It is concluded that brain metastases can be categorized into early stage (Cho), intermediate stage (lipid, higher Cho) and late stage metastases (Lact, lower Cho).
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PMID:1H MR spectroscopy detection of lipids and lactate in metastatic brain tumors. 888 70

This article outlines the ability of imaging techniques to stage intrathoracic non-small-cell lung cancer, particularly the extent of primary tumour (T stage), and the presence of nodal metastases (N stage). The detection of hilar and mediastinal lymph-node metastases by CT is covered initially, followed by an appraisal of MRI and radionuclide imaging techniques. Finally, the evaluation of mediastinal and chest-wall invasion by CT and MRI is described, and note is made of developing applications of ultrasound and endosonography. Computed tomography remains the standard technique, but its limitations are discussed, as is the value of other complementary imaging techniques.
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PMID:Staging intrathoracic non-small-cell lung cancer. 903 8

99mTc-MIBI is widely used as a tumor-seeking agent for parathyroid tumor, lung cancer, etc. We tried to detect the metastatic lesions of thyroid cancer by 99mTc-MIBI SPECT and evaluated 131I-uptake in the region of 99mTc-MIBI accumulation. Twenty-seven cases of thyroid cancer (23 papillary adenocarcinoma, 3 follicular adenocarcinoma, 1 unknown) were examined by 99mTc-MIBI. All cases were confirmed by surgery. Thyroglobulin was measured in all cases before 99mTc-MIBI SPECT. 131I-therapy (4.5-5.5 GBq) was performed on 24 patients and whole body scintigram was taken 7-10 days after. Thirty minutes after an injection of 99mTc-MIBI (740 MBq), SPECT with a three-head gamma camera was performed. Abnormal accumulation of 99mTc-MIBI was noted in 14 patients, all cases detected on CT or MRI. In 11 of the 13 cases in which accumulation was not visualized, no metastasis was detected. Most cases of abnormal accumulation on 99mTc-MIBI showed a high level of thyroglobulin. Metastatic lesions of follicular adenocarcinoma in three patients (right humerus, axillary region and sternum) showed strong accumulation of 99mTc-MIBI, and 131I was strongly taken up in these lesions. 131I was also taken up in the metastatic lesions of papillary adenocarcinoma with marked accumulation of 99mTc-MIBI. 99mTc-MIBI did not accumulate in a case with diffuse pulmonary uptake of 131I. 99mTc-MIBI SPECT could detect occult metastatic lesions in the soft tissue more clearly than CT or MRI. In conclusion, 99mTc-MIBI study might be useful as a follow-up study of patients after surgery for thyroid cancer.
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PMID:[Usefulness of 99mTc-MIBI SPECT in the metastatic lesions of thyroid cancer]. 907 95

Problems of a correct approach to radiation therapy of lung cancer are reported. The identification of factors related to the site and function (respiratory motion, critical organs etc) allows systematization of a Quality Assurance procedure in treatment planning and implementation. Already in the diagnostic phase modern technology (CT, MRI) can supply useful information for a more correct staging and consequently for a more suitable treatment, while in the therapeutic phase it helps in the identification of irradiation volumes (simulation), in the use of treatment plans on CT imaging (multislide, 3D), in the use of conformal therapy able to increase the target dose while sparing the critical organs, and in checking correct patient set-up.
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PMID:Quality assurance procedures in radiotherapy of lung cancer. 912 46

Nuclear medicine plays a major role in the diagnosis of pulmonary embolism as well as in other lung diseases. Important innovations have concerned in recent years the equipment and radiopharmaceuticals. In ventilation studies the use of technegas, a monodisperse aerosol able to supply images of the same quality or even superior to gas images, is widespread in the clinical practice. Significant clinical results in the evaluation of acute thromboembolism have been achieved with antifibrin monoclonal antibodies and radioactive peptides specific for activated platelet receptors. Primary lung cancer and its metastases can now be visualized with tracers used for the study of myocardial perfusion (sestaMIBI, tetrofosmin) or labeled ocreotide, a molecule able to recognize lung tumors with somatostatin receptors. 99mTc-NR-LU-10 Fab immunoscintigraphy was shown to be very sensitive for tumors, while the major role of PET in the differential diagnosis of solitary pulmonary nodule, in the initial staging and in the response assessment to lung cancer therapy, is confirmed. SPECT is widespread in the clinical field with the use of 2-3 head gamma cameras and the possible combined imaging with CT or MRI. The use of PET with common gamma cameras with appropriate collimation systems or coincident recording without collimation is being studied. PET is used in the study of tumor metabolism as well as in the evaluation of intra-and extravascular lung water, regional blood flow and pulmonary vascular permeability. PET studies of vascular lung physiology as well as of receptor physiology, amine accumulation and clearance and drug transport to the areas of healthy or impaired lung, were also shown to be fundamental.
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PMID:Advances in pulmonary nuclear medicine. 914 15


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