Staging non-small cell lung cancer.
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.
Quint
Leslie Eisenbud
LE
Department of Radiology, University of Michigan Health System, Ann Arbor, MI 48109-0030, USA. lequint@umich.edu
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D009367:Neoplasm Staging / Q000379:methods*; D010997:Pleural Neoplasms / Q000556:secondary; D011859:Radiography; D012680:Sensitivity and Specificity; D035441:Thoracic Wall / Q000000981:diagnostic imaging / Q000473:pathology