Whole body bone scintigram and stage classification of the patients with adenocarcinoma of lung

One hundred and six patients having adenocarcinoma of the lung were studied by whole body bone scanning with 99mTc-phosphates in connection with their clinical stages. Abnormal accumulation was found in 64 patients (60%). There were 64 patients who received surgical treatment. Among these 64 patients, 38 underwent bone scanning within 3 months after the establishment of their clinical stages. Twenty-two of them were classified as Stage I clinically. Pathological stage classification after the surgery revealed these 22 to be classified into 3 groups; 6 for Pathological Stage I, 4 for Pathological Stage II and 12 for Pathological Stage III. None of these 6 in Stage I showed abnormal accumulations. However, 1 of 4 in Stage II and 6 of 12 in Stage III were found to have abnormal accumulations. Therefore, if bone scintigrams had been taken into consideration for clinical stage classification, 7 patients would have never been placed into Clinical Stage I and could be expected more precise treatment. The authors recommend application of the results of whole body bone scanning to stage classification of adenocarcinoma of the lung. Needle biopsy is also recommended to confirm the metastasis at the site of radioisotope accumulation in the rib.