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Diagnostic imaging in the preoperative management of lung cancer

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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.

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Kazuhiro Imai and the co-authors have no conflicts of interest to declare.

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  1. Department of Chest (& Endocrinological) Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan

    Kazuhiro Imai, Yoshihiro Minamiya, Hajime Saito, Satoru Motoyama, Yusuke Sato, Aki Ito, Kei Yoshino, Satoshi Kudo, Shinogu Takashima, Yasushi Kawaharada, Nobuyasu Kurihara, Kimito Orino & Jun-ichi Ogawa

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Imai, K., Minamiya, Y., Saito, H. et al. Diagnostic imaging in the preoperative management of lung cancer. Surg Today 44, 1197–1206 (2014). https://doi.org/10.1007/s00595-013-0660-z

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