Imaging is an integral component of comprehensive clinical evaluation and management of patients with nonsmall cell lung (NSCLC). CT is almost universally used to evaluate patients with NSCLC and is useful in assessing the primary tumor in terms of size, location and extent of local invasion. Although CT is useful in defining the primary tumor, there are limitations in assessing chest wall or mediastinal invasion. Magnetic resonance (MR) can be an important adjunct to CT because of its superior soft-tissue contrast resolution and multiplanar imaging and is particularly useful in the evaluation of patients with superior sulcus tumors. The presence and location of nodal metastases are important in patient management. Although CT is usually used to detect nodal metastases (nodes > 1-cm in short-axis diameter), the accuracy is not optimal. FDG-PET improves the detection of nodal metastases and has a higher sensitivity (83%) and specificity (92%) than CT (sensitivity 20%, specificity 78%). Extrathoracic metastases are common in patients with NSCLC at presentation. However, imaging performed in the detection of these metastases is not precisely defined. CT is the primary modality used in the detection of intra-and extrathoracic metastases while MR is used to detect brain metastases or to further evaluate findings that are equivocal on CT. Whole-body FDG-PET has a higher sensitivity (83%) and specificity (90%) than CT in detecting extrathoracic metastases and is reported to prevent inappropriate resection in 20% of patients considered resectable by standard imaging and clinical evaluation.
|Title of host publication||Lung Cancer|
|Subtitle of host publication||Fourth Edition|
|Number of pages||11|
|State||Published - 27 May 2014|
- Computer tomography
- Lung cancer
- Positron emission tomography