Diagnostic value of 67Ga-scintigraphy in chest surgery.

Diagnostic value of 67Ga-scintigraphy in chest surgery. Gallium-67 (67Ga) has a high affinity for malignant tissue. The diagnostic value of 67Ga-scintigraphy for differentiating between malignant and benign disease was studied in 109 patients with lesions of the chest discovered by radiological examination. Histological diagnoses were obtained in all the patients after the study was concluded. All the patients with sarcoidosis showed intense uptake of 67Ga in their lesions. The diagnostic specificity for the rest of the material was 94%, the diagnostic sensitivity 76%, and the prevalence 76 %. 67Ga-scintigraphy appears to be a valuable addition to thoracic diagnostic methods. The problem whether a process discovered in the lungs, mediastinum or pleura by radiological examination should be considered as potentially malignant or benign is often presented to the chest surgeon. In the case of mediastinal lesions this problem is fairly easily solved. Hilar lymph node enlargements often have a characteristic radiological appearance, and a histological diagnosis may usually be obtained from a biopsy of lymph nodes in the neck or by mediastinoscopy. In other types of mediastinal lesions, exploratory surgery will usually be carried out owing to the risk of compression and the high incidence of malignancy. Hence a ;histological diagnosis of mediastinal lesions will generally be obtained. Infiltrative lesions in the lungs, on the other hand, more often present diagnostic problems. Conventional methods frequently fail to reveal the nature of such lesions, and an exploratory thoracotomy may be a major operation involving severe risk, especially to patients with impaired pulmonary function. However, it may often be necessary to carry out an exploratory thoracotomy which will eventually reveal the presence of a benign lesion. Obviously any additional examination which does not expose the patient to risk and which may help to disclose whether a pulmonary infiltrate discovered by radiographic examination is malignant or benign will be of great value. Several authors have confirmed the observation by Edwards and Hayes (1969, 1970) that the radio-nuclide gallium-67 (67Ga) when injected intravenously in carrier-free solution has a high and apparently specific affinity for malignant tissue. Hence it has been possible by means of 67Ga-scintigraphy to visualize malignant tumours in various organs (Higasi et al. The purpose of t'he present work has been to estimate the diagnostic value of 67Ga-scintigraphy for differentiating between malignant and benign tumours of the chest. PATIENTS One hundred and nine patients (73 men and 36 women between 22 and 71 …