NUCLEAR-MEDICINE IMAGING IN LUNG-CANCER - A PLENTY OF POSSIBILITIES (REVIEW)

The evaluation of the anatomical dissemination of lung cancer has a pi votal role in the choice of the most appropriate treatment modality. T he techniques of nuclear medicine are founded on the use of different radiopharmaceuticals capable of exploiting the specific characteristic s of malignant tissues. They may recognise diverse cell densities, gro wth rates, metabolic pathways, antigenic and surface receptor expressi ons. In the past, the use of Co-57-bleomycin and, then, of (67)Gallium has encountered a mixed acceptance among nuclear medicine specialists , with favourable reports claiming their utility, and others with more sceptical opinions. It is generally admitted that both Co-57-bleomyci n and (67)Gallium scintigraphies are quite sensitive and rather accura te. Their use, however, is almost abandoned in favour of more innovati ve and encouraging approaches, including non-specific radio-tracers (( 201)Thallium and Tc-99m-sestamibi), substances useful in particular cl inical applications (the somatostatin analogues I-123-tyr(3) and the I n-111 octreotide for neuronendocrine tumours), radio-labelled monoclon al antibodies, and the recently introduced positron emission tomograph y. Promising results with each of these techniques need to be further substantiated, before their entering into clinical practice. However, the abundance of choices offered by nuclear medicine might reasonably bring forward the ideal noninvasive test. We review the many scintigra phic methods investigated so far and their clinical significance.