title: Diagnostic imaging in the preoperative management of lung cancer.
abstract: Surgical resection is the accepted standard of care for patients with non-small cell lung cancer (NSCLC). Several imaging modalities play central roles in the detection and staging of the disease. The aim of this review is to evaluate the utility of computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and PET/CT for NSCLC staging. Radiographic staging refers to the use of CT as a non-invasive diagnostic technique. However, while the vast majority of patients undergo only CT, CT is a notoriously inaccurate means of tumor and nodal staging in many situations. PET/CT clearly improves the staging, particularly nodal staging, compared to CT or PET alone. In addition, as a result of the increased soft-tissue contrast, MRI is superior to CT for distinguishing between tissue characteristics. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), which is a minimally invasive technique, also has pathological diagnostic potential. Extensive research and the resultant improvements in the understanding of genetics, histology, molecular biology and oncology are transforming our understanding of lung cancer, and it is clear that imaging modalities such as CT, MRI, PET and PET/CT will have an important role in its preoperative management. However, thoracic surgeons should also be aware of the limitations of these techniques.
authors.affiliation: Department of Chest (& Endocrinological) Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan, i-karo@mui.biglobe.ne.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Imai
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Minamiya
authors.forename: Hajime
authors.initials: H
authors.lastname: Saito
authors.forename: Satoru
authors.initials: S
authors.lastname: Motoyama
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sato
authors.forename: Aki
authors.initials: A
authors.lastname: Ito
authors.forename: Kei
authors.initials: K
authors.lastname: Yoshino
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kudo
authors.forename: Shinogu
authors.initials: S
authors.lastname: Takashima
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kawaharada
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Kurihara
authors.forename: Kimito
authors.initials: K
authors.lastname: Orino
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Ogawa
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000556:secondary; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed