ABSTRACT
Lung cancer is among the most common type of cancers and is a leading cause of cancer-related deaths with smoking representing the leading risk factor. It is classified into non-small cell lung cancer [NSCLC] representing 70-80% of cases and small cell lung cancer [SCLC] which has neuroendocrine properties with poor outcome. Staging of NSCLC is based on the TNM classification system while SCLC was usually classified into limited and extensive disease, though the use of TNM staging system for SCLC is recommended. Imaging studies are used to determine the pre-operative staging of lung cancer. Accurate radiological staging is essential to determine tumor resectability as well as to avoid futile surgeries and to assess patient's outcome. Moreover, radiological examinations are used for the evaluation of tumor response to treatment. This manuscript will review the utilization of imaging studies in the management of lung cancer based on the most recent guidelines by the National Comprehensive Cancer Network [NCCN].
ABSTRACT
Fluoro-2-deoxy-D-glucose [FDG]-positron emission tomography [PET] and PET/computed tomography [FDG-PET/CT] is regarded as a standard of care in the management of non-small-cell lung carcinoma [NSCLC] and is a useful adjunct in the characterization of indeterminate solitary lung nodules [SLN], and pre-treatment staging of NSCLC, notably mediastinal nodal staging and detection of remote metastases. FDG-PET/CT has the ability to assess locoregional lymph node spread more precisely than CT, to detect metastatic lesions that would have been missed on conventional imaging or are located in difficult areas, and to help in the differentiation of lesions that are equivocal after conventional imaging. Increasingly FDG-PET/CT is employed in radiotherapy planning, prediction of prognosis in terms of tumor response to neo-adjuvant, radiation and chemotherapy treatment. Evidence is accumulating of usefulness of PET/CT in small cell lung cancer.