Lung cancer staging: the role of computed tomography and magnetic resonance imaging. 1996

L Bonomo, and C Ciccotosto, and A Guidotti, and M L Storto
Department of Radiology, University of Chieti, Ospedale, SS. Annunziata, Italy. bonomo@unich.it

Because complete resection remains the only reliable method of cure of lung cancer, one important aim of preoperative staging is to select patients with localised disease who may benefit from surgery, while avoiding unnecessary thoracotomies in patients with unresectable neoplasm. Computed tomography (CT) of the chest is a valuable method for staging local and regional spread of lung neoplasms, although limitations in its accuracy are well-known. While gross invasion of the mediastinum and major structures as well as the presence of metastatic disease can be easily demonstrated with CT, differentiation between tumour contiguity and subtle invasion of mediastinum or chest wall often remains a problem. Although magnetic resonance imaging (MRI) may have the same limitations as CT, in specific situations it may be superior in diagnosing minimal chest wall or mediastinal invasion. Moreover, MRI is useful in the assessment of patients with superior sulcus tumours as well as in patients with contraindication to intravenous administration of ionic contrast material. Since nodal size is the only useful criterion for evaluating lymph node metastases, CT and MRI show similar, poor accuracies in lymph node staging resulting from both low sensitivity (normal-sized nodes may contain microscopic metastases) and low specificity (enlarged lymph nodes may be reactive). For this reason, if enlarged lymph nodes are detected, further evaluation is recommended before excluding the patient from a potentially curative resection. Advantages and limitations of CT and MRI in the preoperative staging of non-small-cell carcinoma are reviewed in this article. The imaging of small-cell carcinoma is not included because most patients with this cell type do not benefit from surgical resection. Similarly we do not discuss imaging of distant metastases.

UI MeSH Term Description Entries
D008175 Lung Neoplasms Tumors or cancer of the LUNG. Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D008207 Lymphatic Metastasis Transfer of a neoplasm from its primary site to lymph nodes or to distant parts of the body by way of the lymphatic system. Lymph Node Metastasis,Lymph Node Metastases,Lymphatic Metastases,Metastasis, Lymph Node
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008479 Mediastinal Neoplasms Tumors or cancer of the MEDIASTINUM. Cancer of Mediastinum,Mediastinal Cancer,Cancer of the Mediastinum,Mediastinum Cancer,Mediastinum Neoplasms,Neoplasms, Mediastinal,Cancer, Mediastinal,Cancer, Mediastinum,Cancers, Mediastinal,Cancers, Mediastinum,Mediastinal Cancers,Mediastinal Neoplasm,Mediastinum Cancers,Mediastinum Neoplasm,Neoplasm, Mediastinal,Neoplasm, Mediastinum,Neoplasms, Mediastinum
D009367 Neoplasm Staging Methods which attempt to express in replicable terms the extent of the neoplasm in the patient. Cancer Staging,Staging, Neoplasm,Tumor Staging,TNM Classification,TNM Staging,TNM Staging System,Classification, TNM,Classifications, TNM,Staging System, TNM,Staging Systems, TNM,Staging, Cancer,Staging, TNM,Staging, Tumor,System, TNM Staging,Systems, TNM Staging,TNM Classifications,TNM Staging Systems
D010996 Pleural Effusion Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. It is a sign of disease and not a diagnosis in itself. Effusion, Pleural,Effusions, Pleural,Pleural Effusions
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013899 Thoracic Neoplasms New abnormal growth of tissue in the THORAX. Neoplasm, Thoracic,Neoplasms, Thoracic,Thoracic Neoplasm
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography

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