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Ann Thorac Surg 1994;57:838-840
© 1994 The Society of Thoracic Surgeons


Articles

Cerebral imaging in the asymptomatic preoperative bronchogenic carcinoma patient: Is it worthwhile?

F.Hammond Cole, Jr, MD*, James E. Thomas, MD, A.Brian Wilcox, MD, Hollis H. Halford, III, MD

Departments of Radiology and Surgery, Methodist Hospitals of Memphis, and Department of Surgery, University of Tennessee Center for the Health Sciences, Memphis, Tennessee, USA

* Address reprint requests to Dr Cole, 1325 Eastmoreland, Ste 310, Memphis, TN 38104.

The issue of screening for cerebral metastatic disease in the preoperative bronchogenic carcinoma patient remains unsettled and changes with advancing technology. A prospective nonrandomized study was designed to compare contrast magnetic resonance imaging (MRI) with computed tomography (CT) after several clinical situations suggested improved sensitivity for the former study. Patients with clinically operable disease and normal neurologic examinations were referred for both enhanced cerebral CT and MRI studies. Forty-two patients were entered and completed the enhanced CT scan; only 30 tolerated the MRI. The demographic data and histology of the patients appeared fairly typical for a series of operative candidates. No unsuspected metastatic lesion was found in this selected and low-risk group. We conclude that neither MRI nor enhanced CT scan is indicated in the asymptomatic bronchogenic carcinoma patient due to expense and lack of positive findings. Magnetic resonance imaging demonstrated more subtle benign pathology, but this study did not allow comparison of the two techniques in detection of metastatic disease.




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