Staging of bronchial carcinoma

Staging of any tumor, i.e. determination of the extent of the disease, serv es to select the patients who might profit from curative surgical intervent ion or to define those patients with inoperable carcinomas who should be re ferred for other therapies, such as chemotherapy or irradiation. Furthermor e,accurate staging is necessary for assessment of prognosis, for radiation therapy planning, and for differentiation of those with small-cell lung can cer or for follow-up examinations of small-cell lung cancer patients after during and after chemotherapy. The primary radiological staging and diagnos tic modalities for assessment of bronchial carcinomas are computed tomograp hy (CT) of the thorax including liver and adrenal glands, abdominal sonogra phy, and bone scintigraphy. Magnet ic resonance imaging (MRI) should be res erved for specific indications, e.g. infiltration of the chest wall or stag ing of patients with intolerance/allergy to intravenous contrast medium. Th e clinical value of nuclear medicine techniques,such as [F-18]2-fluoride-2- desoxy-D-glucose positron emission tomography (FDG-PET) for evaluation of l ymph nodes and distant metastases, In-111 octreotide/somatostatin receptor scans for staging of small-cell lung cancer, and thallium-201 SPECT are cur rently being assessed in numerous studies,although these techniques are alr eady in routine use. In future these or nuclear medicine techniques, as wel l as techniques using molecular-based contrast material, especially for MR imaging, currently in experimental status, may yield serious potential for staging purposes.