Reliability of gallium scan chest radiography compared to mediastinoscopy for evaluating mediastinal spread in lung cancer.

Abstract

Mediastinoscopy has become a major staging procedure for characterizing mediastinal and hilar tumor spread in lung cancer. As a result, many patients are now identified as having a nonresectable lesion and are saved the possible morbidity and mortality of full thoracotomy. To achieve this advance, however, as many as one half to two thirds of all patients (i.e., those with a negative mediastinoscopy) are subjected to 2 procedures: mediastinoscopy followed by thoracotomy. In an attempt to decrease the number of staging mediastinoscopies, recent reports have dealt with the degree of correlation between chest roentgenography and mediastinoscopy and have concluded that patients with a normal mediastinum on the chest film may be spared a staging mediastinoscopy. This investigation deals with an evaluation of another noninvasive technique, gallium scanning of the lung and mediastinum, in the staging of lung cancer. We report on the degree of correlation between gallium scans, chest roentgenography, and mediasti...