Evaluation of T1NoMo Lung Cancer with CT

La, Parker; Mauro, Matthew A.; Dj, Delany; Cw, King

doi:10.1097/00004728-199111000-00007

Cited by 9 publications

(2 citation statements)

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“…In one series CT did not correctly alter the stage or affect manage-ment in any of 38 T1 tumours [102]. However, others have found evidence of irresectable disease in up to one third of patients and advocate its use [97,103].…”

Section: Distant Metastasis (M) M0mentioning

confidence: 96%

Staging intrathoracic non-small-cell lung cancer

Hanson

Armstrong

1997

Eur Radiol

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This article outlines the ability of imaging techniques to stage intrathoracic non-small-cell lung cancer, particularly the extent of primary tumour (T stage), and the presence of nodal metastases (N stage). The detection of hilar and mediastinal lymph-node metastases by CT is covered initially, followed by an appraisal of MRI and radionuclide imaging techniques. Finally, the evaluation of mediastinal and chest-wall invasion by CT and MRI is described, and note is made of developing applications of ultrasound and endosonography. Computed tomography remains the standard technique, but its limitations are discussed, as is the value of other complementary imaging techniques.

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Section: Distant Metastasis (M) M0mentioning

confidence: 96%

Staging intrathoracic non-small-cell lung cancer

Hanson

Armstrong

1997

Eur Radiol

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“…Some authors focused on clinical T1N0M0 tumours and concluded that routine CT scanning did not correctly stage their patient population [65]. However, others have found evidence for unresectable spread of disease in up to one-third of patients with T1N0M0 lung cancer and advocate routine preoperative CT in these patients [66]. Other variables such as differences in CT scanners, the scanning technique used and variation in the compulsiveness of surgical staging may also affect sensitivity and specificity of CT.…”

Section: The N-factormentioning

confidence: 99%

Computed tomography in staging for lung cancer

Verschakelen¹,

Bogaert²,

Wever³

2002

Eur Respir J

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Computed tomography (CT) provides the most detailed imaging information, hence it is generally used as a routine imaging procedure in the tumour, node, metastasis (TNM)-staging of patients with lung cancer. However, despite the continuously ongoing process of improvement in CT scanning in which today9s CT scanners combine fast acquisition, fast data reconstruction and high detail, the technique has important limitations.CT can, in some cases, very accurately show tumour extent within, and predict spread beyond the lung. However, the question of whether the tumour has invaded the chest wall or the mediastinum and, if so, whether it is still potentially surgically curable often remains unanswered. In addition, the only sign for predicting lymph node involvement using CT is enlargement. Many studies have shown that this sign is not very reliable. CT is also, with success, being used to evaluate distant metastases although other techniques such as ultrasound and magnetic resonance imaging can have similar or higher accuracies.Despite these well-known limitations, computed tomography will most likely stay the routine imaging procedure for determining resectability and for assessing intra-and extrathoracic spread of lung cancer. The improvement in technology will probably result a better T-staging. The role of computed tomography in nodal staging remains important. It offers the surgeon a road map of the lymph nodes and guides towards the nodes that need biopsy. Combining computed tomography with positron emission tomography, when it becomes more widely available, will add functional images to the detail of computed tomography and will not only improve nodal staging but will probably also allow a better evaluation of distant metastasis and reduce the number of unnecessary interventional procedures.

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