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December 12, 1977

Indications for Brain Scans

JAMA. 1977;238(24):2599-2600. doi:10.1001/jama.1977.03280250025012

To the Editor.—  I have read with interest the article by Wittes and Yeh (238:506-507) in which they state that brain scans are not useful for screening patients without clinical evidence of metastases from oat cell carcinoma. There has been some controversy on this issue, particularly in light of conflicting reports that appeared simultaneously in 1976.1,2While the article by Wittes and Yeh was in press, we3 published one on this subject of the usefulness of brain scintigraphy in the detection of clinically occult brain metastases. Briefly, in 136 patients who had various types of cancer (52%, carcinoma of the lung) and who at the time of brain scintigraphy lacked clinical evidence of brain metastases, neither dynamic nor static brain scintigraphy with sodium pertechnetate Tc 99m identified silent intracerebral metastases. The only two abnormal static studies found were due to skull metastases in one case and dural metastases