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Early detection and localization of lung cancer
62 223
222 ProGnostic Lwg Christian
GoergJ40;
Depertment Ilsrturg,
of
Liver
U.S.Schwerk,YD;
W.Uolf,m;
19Bo and December 1990,
revealed
cancer
29).
Sowgraphic
liver
patterns
prognostic
significance after
the
both histoloGical small
of
in 81 Patients
liver
liver
Response to
Best
response according
mtastasis
(6
remission. illness In
All
1
other
ebdaninal
(41
(85
rmltifocal examinations
SCLC, 23 WSCLC).
ultresmrd
20 wt
For
was seen
of 41 with
in
SCLC (49
achieved afterthe firsttuo cyclesuith only 7
was
SCLC,
to
WSCLC (22 X),
the
to abdaninal
followup
in 64 Patients
according
and
with
NSCLC)
patients
exhibiting exhibited
complete
liver
a progressive
metastasis
OP non-response
on ultrasand.
sumwy,
follow-up
sonogrephy exmnination
metastasis
regression
associated justified
with
is of
reliable liver
subsequent
poor
with
mtastases to
prognosis
the
and
respect in first
to
lung
the
two cyles
continued
diagnosis
cancer. of
treatment
A
and
lack
of
therapy
is
cannot
t-s
in such patients.
IN VI”0 SOMATOSTATIN RECEPTOR IMAGING IN LUNG CANCER. G.S. Kho. E.P. tinning, S.W.I. Lambens, W.H. Bakker, H.Y. Oei, T.A.W. Splinter, C. Hilvsring, D.I. Kwekkeboom. Depanmenll of Nuclear Medicine, Medicine, Fulmonology, and Oncology, Univeraily Hospital fijkzigt, Rotterdam, Tbe Netherlands. Somatatrdin receptora have been characterized on biopsy specimensfrom small cell lung carcinonu (SCLC) and on cultured human SCLC cells. Recently, we described tbr in viva of various somatosutin receptor positive turnon, after injection of ‘%Ty?-
ocucolide, a ndiolalxled viualition
somatostatin analog. Subsequently, an easier technique of
of somato&atin receptors using a somatastatinanalog coupled to “‘In
was
developed. Here, (~6 report the reudu~of scintigmphy with ‘% or “‘In-labeled ocweotide in patientswith various types of lung cmcer. Using ‘%Ty?-ocVmtidc
scintigmpby, we were able lo demonstratetwwr deposit8in 5 of
8 patienta (63%) with SCLC. In 2 patientsunexpectedmetastweswere found. In the patients with SCLC in whom the tuumorwas not visualized, this may have been caused by prior scintigmphy was done in 20 untreated padents, 8 with squamous trutmcnt. “’ In-xtreatide cell turnon.
6 with
SCL.C,
4 with
large
cell
undifferenfiated
cartinom.
and
2 with
adenocucimm of the lung. All these turnon accumulated ndicactivity. Ihe adenocarcinonusand half of the squamouscell carcinomasshowed only a weak accumulation of ndiaactivily. Hislologically proven lymph node involvement or distant metastaaeswere rcfognized atit
injection of “‘in-octreotide in all 5 patients with SCLC,
but in only I of 7
patient8 with mctadasivd nan-SCLC (P
Lung cancer mass surveys are performed for the ultimate purpose of decreasing the death rate of lung cancer. Annual chest X-ray examinations are effective to detect the peripheral type of early stage lung cancer. On the other hand sputum cytology examination is effective for the detection of early stage lung cancer of central type. The relative rate of early stage lung cancer among the total number of lung cancers treated in Tokyo Medical College so far is 4.3%. is 3.7% until 1980 and 5.4% after then. Localization is then performed by fiberoptic bronchoscopy. The findings can be divided into two categories: protruding and superficial types. Tumor localization is sometimes very difficult in cases of early stage superficial squamous cell carcinoma such as carcinoma in situ. The authors developed excimer dye laser equipment for localization of early stage cancer such as cvarcinoma in situ using an excimer dye laser. Fluorescence was recognized in lesions, showing this equipment to be effective to localize even very small malignant lesions.
225
224
vi-lit&
Harubumi Kato, Chimol;iKonaka, Tetsuya Okunaka and Yoshihiro Hayata Departments of Surgery and Cancer Center*, Tokyo Medical College, 6-7-l Nishishinjuku, Shinjuku-ku, Tokyo 160, Japan
cell
OP isoechoic
cm)(75%)
Sonographic
were performed
uith
3
small
was investigated.
the hypoechoic
(under
lung
(NSCLC, n =
described
treatment
chemotherapy
response
were
of
5 out of 23 Patients
patients
LUMJ carnxr
metastasis
lung cancer,
with
pretreatment
(20 X) with
cell
of
liver
metastasis
for
two cycles of
EARLY DETECTION AND LOCALIZATION OF LUNG CANCER
in
3550
of 410 Patients sonography
of evaluation fist
types
noduled
a total
and non-small
spread (87 X) was fmmd to be typical.
X).
Saldiwerstrasse,
Abdaninal
rnetastesis
(SCLC, n = 52)
ultras&
only
Ultras-and
K.Havemam,l!D.
Philipps-University,
were seen in cur hospital.
lvlg
for
using
Involvement
Germany
staging
X),
of Response to CherotheraW Metastatic
Oncolcgy,
Between January cancer
Value
Cancer with
might be used to deteminc
the extent of the diseass
We carlude thal in the majority of patientswith SCLC the tumor and ila metastaoess can bo visualized using oclxuide scintigmphy. However, Ibe value of this new technique in terma of specificity and earuitivily require further studiesin a larger g-p of pat&u.
USEFULNESS OF CINE MR IMAGING IN EVAL-UATION OF CARDIO-VASCULAR INVASION OF LUNG CANCERS OR MEDIASTINAL TUMORS. Osada H.. Nakajima Y., Yokote K., Taira Y.. Kurisu S., and Yamate N. Dept. Surg. Div. III, St. Marianna Medical College, Kawasaki.. IJAPAN Purpose: An hypothesis was tested, that tine MR motion pictures could distinguish a noninvasion, from a questionable one. of z lung cancer or a meij.as-tinal tumor co ch:? heart or great vessels. :.:aterial ant Xet,loc;s: In 10 patients (6 lung cancer and 4 mediastinal tumor) in which a tumor invaion to the atrium or the great vessels was suspected on static CT/MR images, tine MR images were obtained per planes perpendicular to the interface in question, using a computer soft Cardiac Package,, incorporated to a Philips Gyroscan-Superconductive, 1.5T. When the motion picture showed either a transient low signal band through the interface or a pulsatile motion of the tumor with a phase different from that of the neighbouring cardiovascular structures, it was regarded as a sign of no-real-invasion.(Typical examples can be shown in a video). Xesults: Nine of 10 patients thus underwent surgery ana proved free i'rom invasion as expected. Conclusion: Cine ~1% images are valuable in picking up surgical candidates with possible cardio--vascular invasion of chest tumors.
222 ProGnostic Lwg Christian
GoergJ40;
Depertment Ilsrturg,
of
Liver
U.S.Schwerk,YD;
W.Uolf,m;
19Bo and December 1990,
revealed
cancer
29).
Sowgraphic
liver
patterns
prognostic
significance after
the
both histoloGical small
of
in 81 Patients
liver
liver
Response to
Best
response according
mtastasis
(6
remission. illness In
All
1
other
ebdaninal
(41
(85
rmltifocal examinations
SCLC, 23 WSCLC).
ultresmrd
20 wt
For
was seen
of 41 with
in
SCLC (49
achieved afterthe firsttuo cyclesuith only 7
was
SCLC,
to
WSCLC (22 X),
the
to abdaninal
followup
in 64 Patients
according
and
with
NSCLC)
patients
exhibiting exhibited
complete
liver
a progressive
metastasis
OP non-response
on ultrasand.
sumwy,
follow-up
sonogrephy exmnination
metastasis
regression
associated justified
with
is of
reliable liver
subsequent
poor
with
mtastases to
prognosis
the
and
respect in first
to
lung
the
two cyles
continued
diagnosis
cancer. of
treatment
A
and
lack
of
therapy
is
cannot
t-s
in such patients.
IN VI”0 SOMATOSTATIN RECEPTOR IMAGING IN LUNG CANCER. G.S. Kho. E.P. tinning, S.W.I. Lambens, W.H. Bakker, H.Y. Oei, T.A.W. Splinter, C. Hilvsring, D.I. Kwekkeboom. Depanmenll of Nuclear Medicine, Medicine, Fulmonology, and Oncology, Univeraily Hospital fijkzigt, Rotterdam, Tbe Netherlands. Somatatrdin receptora have been characterized on biopsy specimensfrom small cell lung carcinonu (SCLC) and on cultured human SCLC cells. Recently, we described tbr in viva of various somatosutin receptor positive turnon, after injection of ‘%Ty?-
ocucolide, a ndiolalxled viualition
somatostatin analog. Subsequently, an easier technique of
of somato&atin receptors using a somatastatinanalog coupled to “‘In
was
developed. Here, (~6 report the reudu~of scintigmphy with ‘% or “‘In-labeled ocweotide in patientswith various types of lung cmcer. Using ‘%Ty?-ocVmtidc
scintigmpby, we were able lo demonstratetwwr deposit8in 5 of
8 patienta (63%) with SCLC. In 2 patientsunexpectedmetastweswere found. In the patients with SCLC in whom the tuumorwas not visualized, this may have been caused by prior scintigmphy was done in 20 untreated padents, 8 with squamous trutmcnt. “’ In-xtreatide cell turnon.
6 with
SCL.C,
4 with
large
cell
undifferenfiated
cartinom.
and
2 with
adenocucimm of the lung. All these turnon accumulated ndicactivity. Ihe adenocarcinonusand half of the squamouscell carcinomasshowed only a weak accumulation of ndiaactivily. Hislologically proven lymph node involvement or distant metastaaeswere rcfognized atit
injection of “‘in-octreotide in all 5 patients with SCLC,
but in only I of 7
patient8 with mctadasivd nan-SCLC (P
Lung cancer mass surveys are performed for the ultimate purpose of decreasing the death rate of lung cancer. Annual chest X-ray examinations are effective to detect the peripheral type of early stage lung cancer. On the other hand sputum cytology examination is effective for the detection of early stage lung cancer of central type. The relative rate of early stage lung cancer among the total number of lung cancers treated in Tokyo Medical College so far is 4.3%. is 3.7% until 1980 and 5.4% after then. Localization is then performed by fiberoptic bronchoscopy. The findings can be divided into two categories: protruding and superficial types. Tumor localization is sometimes very difficult in cases of early stage superficial squamous cell carcinoma such as carcinoma in situ. The authors developed excimer dye laser equipment for localization of early stage cancer such as cvarcinoma in situ using an excimer dye laser. Fluorescence was recognized in lesions, showing this equipment to be effective to localize even very small malignant lesions.
225
224
vi-lit&
Harubumi Kato, Chimol;iKonaka, Tetsuya Okunaka and Yoshihiro Hayata Departments of Surgery and Cancer Center*, Tokyo Medical College, 6-7-l Nishishinjuku, Shinjuku-ku, Tokyo 160, Japan
cell
OP isoechoic
cm)(75%)
Sonographic
were performed
uith
3
small
was investigated.
the hypoechoic
(under
lung
(NSCLC, n =
described
treatment
chemotherapy
response
were
of
5 out of 23 Patients
patients
LUMJ carnxr
metastasis
lung cancer,
with
pretreatment
(20 X) with
cell
of
liver
metastasis
for
two cycles of
EARLY DETECTION AND LOCALIZATION OF LUNG CANCER
in
3550
of 410 Patients sonography
of evaluation fist
types
noduled
a total
and non-small
spread (87 X) was fmmd to be typical.
X).
Saldiwerstrasse,
Abdaninal
rnetastesis
(SCLC, n = 52)
ultras&
only
Ultras-and
K.Havemam,l!D.
Philipps-University,
were seen in cur hospital.
lvlg
for
using
Involvement
Germany
staging
X),
of Response to CherotheraW Metastatic
Oncolcgy,
Between January cancer
Value
Cancer with
might be used to deteminc
the extent of the diseass
We carlude thal in the majority of patientswith SCLC the tumor and ila metastaoess can bo visualized using oclxuide scintigmphy. However, Ibe value of this new technique in terma of specificity and earuitivily require further studiesin a larger g-p of pat&u.
USEFULNESS OF CINE MR IMAGING IN EVAL-UATION OF CARDIO-VASCULAR INVASION OF LUNG CANCERS OR MEDIASTINAL TUMORS. Osada H.. Nakajima Y., Yokote K., Taira Y.. Kurisu S., and Yamate N. Dept. Surg. Div. III, St. Marianna Medical College, Kawasaki.. IJAPAN Purpose: An hypothesis was tested, that tine MR motion pictures could distinguish a noninvasion, from a questionable one. of z lung cancer or a meij.as-tinal tumor co ch:? heart or great vessels. :.:aterial ant Xet,loc;s: In 10 patients (6 lung cancer and 4 mediastinal tumor) in which a tumor invaion to the atrium or the great vessels was suspected on static CT/MR images, tine MR images were obtained per planes perpendicular to the interface in question, using a computer soft Cardiac Package,, incorporated to a Philips Gyroscan-Superconductive, 1.5T. When the motion picture showed either a transient low signal band through the interface or a pulsatile motion of the tumor with a phase different from that of the neighbouring cardiovascular structures, it was regarded as a sign of no-real-invasion.(Typical examples can be shown in a video). Xesults: Nine of 10 patients thus underwent surgery ana proved free i'rom invasion as expected. Conclusion: Cine ~1% images are valuable in picking up surgical candidates with possible cardio--vascular invasion of chest tumors.