ABSTRACT
Introduction According to recent estimates there were 172 570 new cases and 163 510 deaths from lung cancer in 2005 and these accounted for 28% of deaths from cancer in the United States.1 When identified early, non-small cell lung carcinoma is routinely resected with survival rates of 40-85%.2
Unfortunately, most lung cancers present at an advanced stage resulting in a dismal overall 5-year survival of 15%.3
Chest radiography was the first imaging technique to advance the diagnosis and staging of lung cancer and still plays a role.4 However, plain chest radiography and tomography have largely been supplanted by newer imaging techniques such as computed tomography (CT) or positron emission tomography (PET). CT scanning is currently the cornerstone imaging study for diagnosis and staging of lung cancer. Since its introduction in 1973 and widespread deployment in the 1980s it has become the indispensable technology for work-up of lung cancer. Many national organizations including the American College of Chest Physicians and American Thoracic Society5 list CT prominently in their respective lung cancer guidelines. In general a chest CT is obtained in all patients with known or suspected lung cancer to help characterize the nodule, determine best biopsy or surgical approach, and assess the locoregional extent. Fluorodeoxyglucose (FDG)-PET is a newer modality that is rapidly evolving into the cornerstone imaging technique in the diagnosis and staging of lung cancer. In this chapter we identify some of the clinical questions that arise during diagnosis and staging of lung cancer, and explore the role of imaging in answering those questions.
