Nuclear medicine techniques in the management of bronchogenic carcinoma

Perfusion scanning of the lung is the method of choice in assessing preoperative pulmonary partial function and predicting functional operability. In addition, the quantitative perfusion scan gives an estimation of the extent of surgery. If perfusion in the tumor-affected lung is less than 30% of the total pulmonary blood flow, pneumonectomy has to be anticipated. With a perfusion of less than 10%, technical and prognostic inoperability is predicted. In M-staging, bone scanning is still the most sensitive technique available and should be used for preoperative screening, while other imaging techniques - like sonography and CT scanning - have replaced liver and brain scanning. Nuclear medicine techniques using tumoraffin substances have not achieved wide clinical application, but tumor scintigraphy with radiolabeled monoclonal tumor markers may become an important tool in the management of bronchogenic carcinoma in the near future. (orig.)