Imaging to optimally stage lung cancer: Conventional modalities and PET/CT

Accurately staging patients with lung cancer is important in determining treatment options and prognoses. Staging allows the distinction of patients who are candidates for surgical resection from those with inoperable disease who may be treated with chemotherapy and/or radiation therapy. Conventional imaging plays an essential role in the noninvasive and invasive methods of the evaluation and staging of patients with non-small-cell lung cancer (NSCLC). Imaging modalities used for staging include chest radiography, chest computed tomography (CT), abdominal CT, brain CT or magnetic resonance imaging, bone scans, and ¹⁸F-2-deoxy-d-glucose positron emission tomography (PET). Recently, PET/CT, the integration of the functional data of PET with the anatomic data of CT, has emerged as a modality to potentially change the way patients are evaluated. This article reviews current recommendations regarding the staging of patients with NSCLC and addresses the role of PET/CT.