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• W2020912648 abstract "To the Editor:In an article that appeared in the December 1992 issue of Chest, Silvestri et al1Silvestri GA Lenz JE Harper SN Morse RA Colice GL The relationship of clinical findings to CT scan evidence of adrenal gland metastases in the staging of bronchogenic carcinoma.Chest. 1992; 102: 1748-1751Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar conclude that computed tomographic (CT) scans through the adrenal glands “are unnecessary when staging newly diagnosed bronchogenic carcinoma if the findings from the initial clinical evaluation are normal.” The implication is that under these circumstances “CT scans of the adrenal glands need not be a routine part of the evaluation of bronchogenic carcinoma.”Imaging the upper abdomen during chest CT examination is performed routinely in virtually all radiology departments, regardless of the reasons for the examination. On modern scanners it requires approximately one extra minute of time, and there is no additional charge. It is a “freebie,” like observing the trachea during bronchoscopy for a lung lesion.In my experience as a radiologist, the normal clinical evaluation (history, physical examination, and laboratory studies), which in the study by Silvestri et al rendered adrenal imaging unnecessary, has usually not been completed on patients referred for CT examination of suspected bronchogenic carcinoma. Many of these individuals are outpatients or are having their CT examination concomitant with their laboratory workup. I accept the authors' conclusions that normal clinical findings make an adrenal or liver lesion unlikely to represent a metastasis. However, assuming good clinical judgment, the information that these organs are normal or abnormal will certainly not hurt the patient. The CT appearances of the liver and adrenals may serve as a baseline if metastases are later suspected, as is all too often the case. To the Editor: In an article that appeared in the December 1992 issue of Chest, Silvestri et al1Silvestri GA Lenz JE Harper SN Morse RA Colice GL The relationship of clinical findings to CT scan evidence of adrenal gland metastases in the staging of bronchogenic carcinoma.Chest. 1992; 102: 1748-1751Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar conclude that computed tomographic (CT) scans through the adrenal glands “are unnecessary when staging newly diagnosed bronchogenic carcinoma if the findings from the initial clinical evaluation are normal.” The implication is that under these circumstances “CT scans of the adrenal glands need not be a routine part of the evaluation of bronchogenic carcinoma.” Imaging the upper abdomen during chest CT examination is performed routinely in virtually all radiology departments, regardless of the reasons for the examination. On modern scanners it requires approximately one extra minute of time, and there is no additional charge. It is a “freebie,” like observing the trachea during bronchoscopy for a lung lesion. In my experience as a radiologist, the normal clinical evaluation (history, physical examination, and laboratory studies), which in the study by Silvestri et al rendered adrenal imaging unnecessary, has usually not been completed on patients referred for CT examination of suspected bronchogenic carcinoma. Many of these individuals are outpatients or are having their CT examination concomitant with their laboratory workup. I accept the authors' conclusions that normal clinical findings make an adrenal or liver lesion unlikely to represent a metastasis. However, assuming good clinical judgment, the information that these organs are normal or abnormal will certainly not hurt the patient. The CT appearances of the liver and adrenals may serve as a baseline if metastases are later suspected, as is all too often the case. Relationship of Clinical Findings to CT Scan Evidence of Adrenal Gland Metastases in the Staging of Bronchogenic CarcinomaCHESTVol. 105Issue 5PreviewTo the Editor: Full-Text PDF" @default.
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• W2020912648 title "Relationship of Clinical Findings to CT Scan Evidence of Adrenal Gland Metastases in the Staging of Bronchogenic Carcinoma" @default.
• W2020912648 cites W1998918779 @default.
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• W2020912648 doi "https://doi.org/10.1378/chest.105.5.1626a" @default.
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