Non-Small Cell Lung Cancer - Diagnostic Tests

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Highlights	Diagnostic Tests	Investigative Agents
Introduction	Staging Systems	Resources
Causes	Treatment Options by Stages	References
Symptoms	Surgical Procedures	References
Risk Factors	Radiation Treatments
Lifestyle Changes	Chemotherapy Treatments

PET may be a good imaging technique for staging lung patients thought to have early stage lung cancer after other testing. These patients are considered candidates for surgery intended to cure. But if a PET scan identifies previously undetected spread of the cancer elsewhere in the body, the patient may be able to avoid unnecessary surgery.

However, compared to traditional staging with CT scans, PET-CT may also wrongly diagnosis some with more advanced cancer than they actually have, possibly leading to the incorrect treatment.

Magnetic Resonance Imaging. Magnetic resonance imaging (MRI), an imaging procedure that uses radio wave energy, is frequently used instead of CT scanning to locate brain and bone tumors that have spread from the lung.

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Biopsy Procedures

Biopsies of lung tissue are needed to confirm lung cancer. This requires invasive procedures that may vary from simple needle aspiration to chest surgery.

Needle Aspiration. Sometimes, a biopsy specimen is obtained by inserting a needle between the ribs, and then guiding it with the use of CT scans, ultrasound, or fluoroscopy (a device allowing an x-ray view). Specific techniques include transbronchial or transthoracic needle aspiration (TBNA or TTNA) or endoscopic ultrasound-guided needle aspiration (EUS-NA). Their use depends on how much of the area can be observed with less invasive imaging methods. There is a 5 -10% risk for bleeding or collapsed lung with needle aspiration.

Thoracoscopy. Thoracoscopy is usually very effective for diagnosing cancer in the outer areas of the lungs, or those involving the pleura (membrane surrounding the lungs). This is a surgical procedure that uses a fiber optic tube to view the area. The procedure requires general anesthesia. The surgeon passes surgical instruments and a fiber optic tube through a small incision in the chest. The tube has a camera in it, which allows the surgeon to look at the lungs on a video screen.

Bronchoscopy. Bronchoscopy can help locate cancer that develops in the central areas and major airways of the lung (usually squamous or small-cell cancer). The procedure is done as follows: