Diagnostic imaging techniques in staging of peripheral non-small cell lung cancer spreading

Aim. To develop a personalized approach for using radiologic and nuclear examination methods diagnostics to improve early diagnosis of bone and brain metastases in patients with peripheral non-small cell lung cancer.

Methods. The first group included 1473 patients with peripheral non-small cell lung cancer, who underwent chest X-ray, abdominal and pelvic ultrasonography, bone scintigraphy, and chest, abdominal and pelvic X-ray computed tomography with intravenous contrast from 2006 to 2010 for diagnosing remote metastases. The second group included 55 patients with peripheral non-small cell lung cancer, who underwent comprehensive examination of the full skeleton using X-ray computed tomography and magnetic resonance imaging, single-photon emission computed tomography, positron-emission tomography. The results of brain magnetic resonance imaging in 40 patients (group 3) with peripheral small cell lung cancer with brain metastases were also analyzed.

Results.In peripheral non-small cell lung cancer, bone (23.9%) and brain (14%) metastases were the most frequent. The risk for bone metastases was significantly higher in patients with adenocarcinoma (p

Conclusion. For timely diagnosis of bone metastases, it is reasonable to administer positron-emission tomography with Fludeoxyglucose (18F) to all potentially resectable patients with peripheral small cell lung cancer, which in addition reveals metastases in other body regions. Brain magnetic resonance imaging should be administered if the primary tumor was detected.