The role of imaging in screening, diagnosis and staging of Non-Small Cell Lung Cancer (NSCLC)

摘要

Imaging plays a vital role in the management of NSCLC including diagnosis, staging and follow up. Computerised tomography (CT) is of value not only in the diagnosis of lung cancer, but also for screening and guiding intervention. CT and magnetic resonance imaging (MRI) are used in staging and provide anatomical information but have well known limitations in differentiating reactive from malignant nodes, fibrosis from active disease and in defining the extent of invasion. MRI, with its superior soft tissue contrast provides optimal information on brachial plexus and central nervous system involvement. Functional imaging using 2-18 fluoro-deoxyglucose positron emission tomography (FDG-PET) is increasingly being used to provide unique information and when combined with anatomic imaging will provide better staging information for both local disease and the extent of metastases. FDG-PET or 99mTc-depreotide may help in deciding which lesions need further investigation and the most appropriate lesion to biopsy. Multidetector CT is being used to detect lung cancer at an early stage when it is potentially curable by surgery although many problems exist, particularly the high false positive rates requiring further investigation, which will have implications on cost effectiveness for lung cancer screening programs.