Radiology 2005; 237:803-818.
Munden RF, Swisher SS, Stevens CW, Stewart DJ.
Lung cancer is the most common type of cancer and is the leading cause ot cancer deaths in the United State* for both men and women. Even though the 5-ycar survival rate of patients with lung cancer remains dismal at 14% for all cancer stages, treatments are improving and newer agents for lung cancer appear promising. Therefore, an accurate assessment of the extent of disease is critical to determine whether the patient is treated with surgical resection, radiation therapy, chemotherapy, or a combination of these modalities. Radiologic imaging plays an important role in the staging evaluation of the patient; however, radiologists need to be aware that there are also important differences in what each specialist needs from imaging to provide appropriate treatment. This article reviews the role of imaging in patienls with rion-smdll cell lung cancer, with an emphasis on the radiologic imaging findings relevant for each specialty.
Lung cancer is the most common type of cancer and is the leading cause of cancer deaths in the United States for both men and women. In 2002, it was estimated that 169 500 cases of lung cancer would be diagnosed and that approximately 154 400 deaths (1) would occur. The problem continues to increase, with an estimated 173 770 new cases and 160 440 deaths in 2004 (2). Despite heroic efforts, the overall 5-year survival rate in patients with lung cancer remains dismal at 14% for all stages (clinical staging): 61% for stage IA, 38% for stage IB, 34% for stage IIA, 24% for stage IIB, 13% for stage IIIA, 5% for stage IIIB, and 1% for stage IV (3).
Staging of newly diagnosed non-small cell lung cancer (NSCLC) is performed according to the International System for Staging Lung Cancer. This system describes the extent of NSCLC in terms of the size, location, and extent of the primary tumor (T descriptor), the presence and location of lymph node involvement (N descriptor), and the presence or absence of distant metastatic disease (M descriptor) (see table 1 in reference 3). Because the extent of the disease determines whether the patient is treated by means of surgical resection, radiation therapy, chemotherapy, or a combination of these modalities, radio-logic imaging plays an important role in the staging evaluation (4,5). Although accurate staging is critical regardless of the treatment method used, there are important differences in what each specialist needs from imaging to provide appropriate treatment. This article reviews the role of imaging in patients with NSCLC, with an emphasis on the radiologic findings relevant for each specialty.