Bekerman C, Hoffer P B, Bitran J D, Gupta R G
Semin Nucl Med. 1980 Jul;10(3):286-301. doi: 10.1016/s0001-2998(80)80007-9.
In spite of localization of gallium in the lungs in a large variety of inflammatory pulmonary diseases, the chest radiograph is and will continue to be the principal diagnostic tool for evaluation of pulmonary inflammatory disease. The 67Ga-citrate scan, however, serves as a study complementary to chest radiography because it indicates the extent, localization, and degree of activity of the inflammatory disease with greater accuracy than do the radiographic studies. It also permits the physician to follow progression of the disease or response to treatment and possible to detect disseminated interstitial disease not visualized on radiographs. Gallium-67 scanning may be used in the evaluation of patients with lymphorecticular neoplasms (Hodgkin's disease and malignant lymphomas) both during initial staging and in evaluation of the response to therapy. The 67Ga-citrate scan is useful in the evaluation of patients with lung cancer provided its limitations are kept in mind. It cannot and should not replace the pathologist's microscope. The scan is useful as a screening test only in patients who have radiographic lesions not consistent with inflammatory disease and in whom invasive diagnostic procedures or exploratory surgery are contraindicated unless the probability of detecting a resectable tumor is high. However, the limited resolution of the scanning system restricts the possibility of detecting lesions before they become radiographically visible. The histologic type of the lesion appears to have no effect on the probability of detection. As a noninvasive procedure, the 67Ga-citrate scan complements mediastinoscopy by indicating which lymph nodes should be biopsied. It is also useful in evaluation of the controlateral hilar node region. The scan frequently detects clinically unsuspected extrathoracic lesions. It may therefore be a useful initial procedure in guiding the work-up of the patient with a known or strongly suspected tumor. The combination of the 67Ga scan with the chest radiograph could provide the information necessary for presurgical clinical staging in patients who have no symptoms that suggest distant metastases. Gallium-67 scans may be useful in indicating the effectiveness of treatment and the sensitivity of a tumor to radiation.
尽管镓在多种肺部炎症性疾病中会在肺部聚集，但胸部X线片过去是、将来也仍将是评估肺部炎症性疾病的主要诊断工具。然而，枸橼酸镓扫描可作为胸部X线摄影的补充检查，因为它比X线检查能更准确地显示炎症性疾病的范围、部位及活动程度。它还能让医生观察疾病的进展或对治疗的反应，并有可能检测出X线片上未显示的弥漫性间质性疾病。镓-67扫描可用于淋巴瘤（霍奇金病和恶性淋巴瘤）患者的初始分期及治疗反应评估。如果牢记其局限性，枸橼酸镓扫描对肺癌患者的评估是有用的。它不能也不应该取代病理学家的显微镜。该扫描仅在那些有不符合炎症性疾病的X线病变且禁忌进行侵入性诊断程序或探查性手术的患者中作为筛查试验有用，除非检测到可切除肿瘤的可能性很高。然而，扫描系统有限的分辨率限制了在病变在X线片上可见之前检测到它们的可能性。病变的组织学类型似乎对检测概率没有影响。作为一种非侵入性检查，枸橼酸镓扫描通过指示哪些淋巴结应进行活检来补充纵隔镜检查。它在评估对侧肺门淋巴结区域时也很有用。该扫描经常能检测出临床上未怀疑的胸外病变。因此，它可能是指导已知或高度怀疑患有肿瘤患者检查的有用的初始程序。对于没有提示远处转移症状的患者，镓-67扫描与胸部X线片相结合可为术前临床分期提供必要信息。镓-67扫描在指示治疗效果和肿瘤对放疗的敏感性方面可能有用。
