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Imaging of lung cancer: Implications on staging and management.

Purandare NC, Rangarajan V - Indian J Radiol Imaging (2015 Apr-Jun)

Bottom Line: Lung cancer is one of the leading causes of cancer-related deaths.Accurate assessment of disease extent is important in deciding the optimal treatment approach.To play an important role in the multidisciplinary management of lung cancer patients, it is necessary that the radiologist understands the principles of staging and the implications of radiological findings on the various staging descriptors and eventual treatment decisions.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India.

ABSTRACT
Lung cancer is one of the leading causes of cancer-related deaths. Accurate assessment of disease extent is important in deciding the optimal treatment approach. To play an important role in the multidisciplinary management of lung cancer patients, it is necessary that the radiologist understands the principles of staging and the implications of radiological findings on the various staging descriptors and eventual treatment decisions.

No MeSH data available.


Related in: MedlinePlus

Superior sulcus tumor. Axial (A) and coronal (B) CT scans show a large mass in the apex of the right lung causing destruction of the first and second ribs (arrows) with erosion of the right half of the vertebral body (arrowheads) suggestive of a superior sulcus tumor
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Figure 16: Superior sulcus tumor. Axial (A) and coronal (B) CT scans show a large mass in the apex of the right lung causing destruction of the first and second ribs (arrows) with erosion of the right half of the vertebral body (arrowheads) suggestive of a superior sulcus tumor

Mentions: They are NSCLCs that arise from the lung apex and invade the chest wall or the soft tissues of the thoracic inlet. They cause clinical signs and symptoms, which together are called Pancoast syndrome. The clinical manifestations include pain in the arm or around the shoulder girdle and Horner's syndrome. Pancoast tumors can be stage T3 or T4. Limited involvement of the chest wall and the lower roots of the brachial plexus (C8 and T1) constitutes T3 stage, whereas extensive involvement including infiltration of C5-C7 nerve roots, esophagus, vertebral body, trachea, and subclavian vessels constitutes T4 disease. Potentially operable tumors are treated with surgery in combination with pre- or postoperative radiation and chemotherapy. Surgery is not performed for tumors that involve the trachea, esophagus, more than 50% of vertebral body, subclavian vessels, and brachial plexus above T1 nerve root.[4647] N2-N3 nodal involvement and presence of distant metastases also preclude surgery. Thus, accurate and high-resolution imaging is necessary to delineate various structures in a crowded and narrow region like the superior sulcus. CT scan is excellent for detection of rib and vertebral erosion as well as for vascular invasion [Figure 16]. However, MRI with its multiplanar capability and higher contrast resolution is used to diagnose involvement of the brachial plexus and extension to the neural foramina and the spinal canal.


Imaging of lung cancer: Implications on staging and management.

Purandare NC, Rangarajan V - Indian J Radiol Imaging (2015 Apr-Jun)

Superior sulcus tumor. Axial (A) and coronal (B) CT scans show a large mass in the apex of the right lung causing destruction of the first and second ribs (arrows) with erosion of the right half of the vertebral body (arrowheads) suggestive of a superior sulcus tumor
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4419420&req=5

Figure 16: Superior sulcus tumor. Axial (A) and coronal (B) CT scans show a large mass in the apex of the right lung causing destruction of the first and second ribs (arrows) with erosion of the right half of the vertebral body (arrowheads) suggestive of a superior sulcus tumor
Mentions: They are NSCLCs that arise from the lung apex and invade the chest wall or the soft tissues of the thoracic inlet. They cause clinical signs and symptoms, which together are called Pancoast syndrome. The clinical manifestations include pain in the arm or around the shoulder girdle and Horner's syndrome. Pancoast tumors can be stage T3 or T4. Limited involvement of the chest wall and the lower roots of the brachial plexus (C8 and T1) constitutes T3 stage, whereas extensive involvement including infiltration of C5-C7 nerve roots, esophagus, vertebral body, trachea, and subclavian vessels constitutes T4 disease. Potentially operable tumors are treated with surgery in combination with pre- or postoperative radiation and chemotherapy. Surgery is not performed for tumors that involve the trachea, esophagus, more than 50% of vertebral body, subclavian vessels, and brachial plexus above T1 nerve root.[4647] N2-N3 nodal involvement and presence of distant metastases also preclude surgery. Thus, accurate and high-resolution imaging is necessary to delineate various structures in a crowded and narrow region like the superior sulcus. CT scan is excellent for detection of rib and vertebral erosion as well as for vascular invasion [Figure 16]. However, MRI with its multiplanar capability and higher contrast resolution is used to diagnose involvement of the brachial plexus and extension to the neural foramina and the spinal canal.

Bottom Line: Lung cancer is one of the leading causes of cancer-related deaths.Accurate assessment of disease extent is important in deciding the optimal treatment approach.To play an important role in the multidisciplinary management of lung cancer patients, it is necessary that the radiologist understands the principles of staging and the implications of radiological findings on the various staging descriptors and eventual treatment decisions.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India.

ABSTRACT
Lung cancer is one of the leading causes of cancer-related deaths. Accurate assessment of disease extent is important in deciding the optimal treatment approach. To play an important role in the multidisciplinary management of lung cancer patients, it is necessary that the radiologist understands the principles of staging and the implications of radiological findings on the various staging descriptors and eventual treatment decisions.

No MeSH data available.


Related in: MedlinePlus