DIAGNOSIS OF BRONCHIAL-CARCINOMA

In addition to conventional chest X-rays in AP and lateral projection, computed tomography of the chest, upper abdomen, and head, percutaneo us ultrasonography of the abdomen, and bone scintigraphy represent the standard procedures for the primary diagnosis and staging of bronchia l carcinoma. Magnetic resonance imaging should be reserved for special situations and patients with allergy to IV contrast medium. The clini cal value of positron emission tomography (PET) primarily with respect to lymph-node staging is currently being evaluated in ongoing studies . Due to the high sensitivity of the listed staging modalities in comb ination with rather low specifity, there is a general tendency towards ''over staging'', which carries certain risk particularly for potenti ally operable patients. Consequently the criteria which indicate inope rability (T3, T4, N2, N3 and, in individual cases, M1) have to be conf irmed histologically by biopsy employing interventional techniques or even by explorative thoracotomy before definite therapeutic decisions are made.