OVERVIEW BY AN ONCOLOGIST - WHAT ARE THE IMAGING NEEDS OF THE ONCOLOGIST AND ONCOLOGICAL SURGEON

Imaging techniques play an important role in the management of the car e of the patient who has suspected or known malignancy. Currently avai lable tests have high sensitivity, but low specificity and high false- positive rates. For example, computed tomography scanning and magnetic resonance imaging provide sensitive cross sectional imaging and have improved the detection of small lesions without increasing etiologic s pecificity. Many masses cannot be further characterized with current i maging studies which may be a particular problem in the assessment of residual disease versus fibrosis. Often, results of these imaging stud ies create new problems and confusion that require additional tests: a nd sometimes invasive approaches in order to obtain definite answers. Clearly, the oncologist and oncological surgeon need new screening tes ts with increased specificity without losing sensitivity for most comm on cancers, and new imaging techniques for staging and follow-up of ve ry small volume tumors without sacrificing specificity. New nuclear me dicine techniques such as positron emission tomography (PET) scan or i mmunoscintigraphy may provide a functional evaluation of a tumor for s creening, staging, and follow-up. Initial results of immunoscintigraph y and PET imaging are very encouraging. They may in the future provide prognostic evaluation addition to anatomical assessment of tumor. Add itionally, these new imaging studies survey the entire body and detect metastases at multiple sites (regional and distal) simultaneously. Th erefore, we should determine the role of these imaging techniques in c arefully controlled prospective trials. Copyright (C) 1997 by W.B. Sau nders Company.