Tracer imaging in lung cancer.

Lung cancer is the leading cause of death from cancer in males. Adequate staging is essential if proper treatment is to be administered. Current morphological imaging modalities are confronted with problems in the staging of lung cancer, in the evaluation of treatment response, and in establishing whether a residual mass is due to fibrosis, residual tumors or local recurrence. Nuclear medicine imaging techniques have advanced from planar gallium-67 citrate scans in the 1970s to multihead-detector single-photon emission tomography for 67Ga, Thallium-201 chloride, technetium-99m SestaMIBI, monoclonal antibodies, and octreotide compounds. Results of positron emission tomography (PET) with fluorine-18 deoxyglucose or carbon-11 methionine are very promising. PET units are now employed in centers all over the world and the recently introduced whole-body PET units will be ideal for the correct staging of malignant diseases. The current status of various nuclear medicine imaging procedures is reviewed. The problems and advantages of each scintigraphic procedure are discussed. It appears that many of the problems that confront morphological imaging will be solved by nuclear medicine techniques in the future.