Staging non-small cell lung cancer

Cancer Imaging. 2007 Oct 22;7(1):148-59. doi: 10.1102/1470-7330.2007.0026.

Abstract

Patients with newly diagnosed non-small cell lung cancer (NSCLC) need accurate tumor staging in order to direct appropriate therapy and establish prognosis; the tumor is usually staged using the TNM system. The major imaging modalities currently used for staging this disease are thoracic computed tomography (CT) (including the adrenal glands) and whole body fluorodeoxyglucose (FDG)-positron emission tomography (PET) scanning. CT is generally most useful in evaluating the T stage, i.e. local spread of the neoplasm, whereas PET is most helpful in assessing the N and M stages, i.e. regional and distant tumor spread, respectively. Integrated CT-PET imaging adds information compared to the use of either modality alone. PET findings frequently lead to upstaging the disease and thus prevent unindicated surgeries. Magnetic resonance imaging (MRI) is helpful in evaluating local extent of disease in patients with superior sulcus tumors and possible brachial plexus involvement. Staging accuracy using any of these imaging techniques is imperfect; therefore, pathologic confirmation of positive findings is recommended, whenever possible, before denying a patient potentially curative therapy.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / pathology
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung / pathology*
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / pathology
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology*
  • Lymphatic Metastasis
  • Mediastinal Neoplasms / diagnostic imaging
  • Mediastinal Neoplasms / secondary
  • Neoplasm Staging / methods*
  • Pleural Neoplasms / secondary
  • Radiography
  • Sensitivity and Specificity
  • Thoracic Wall / diagnostic imaging
  • Thoracic Wall / pathology