Staging of XXXX . Relationship of the clinical evaluation to organ scans.

@entity1 @entity4153 @entity2 @entity153 @entity3
Organ scans are generally performed on @entity1 with @entity153 only when clinical evaluation is suspicious for @entity3 . However, it is not clear whether the clinical abnormalities will direct attention to the single organ which should be scanned, or if all three organs (bone, brain, liver) should be evaluated if any clinical abnormality is present. We investigated the use of triple organ radionuclide scanning and computerized tomography (CT) of the brain in the initial staging of @entity1 with @entity4153 with no obvious @entity3 . Of 122 @entity1 with newly diagnosed @entity2 , 53 met our criteria for further study. Thirty-three (62 percent) of these had at least one clinical abnormality suggestive of @entity3 . Bone scanning detected @entity3 in seven (21 percent) and head CT in two additional @entity1 (6 percent). Brain and liver scanning had no yield. In only five of these nine @entity1 did the clinical abnormality direct attention to the organ with detectable @entity3 . Twenty of the 53 (38 percent) @entity1 had a negative routine clinical evaluation, yet bone scanning showed @entity3 in three (15 percent). We concluded that clinical abnormalities are not specific for the organ in which @entity3 may be detected, so three scans (bone, liver, CT of the brain) should be obtained if there is any suspicion of @entity3 based on history, physical examination, and laboratory tests. The value of bone scanning in clinically normal @entity1 deserves further study.
