Lung cancer stage classification system is correlated with the anatomical extent of the disease based on the characteristics of the primary tumor (T), the invasion of the regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) has been working closely with all of its member organizations throughout the development of the recently published 8th Edition of the TNM classification for lung cancer. The main changes are the following: T component is subdivided by primary tumor size in 1cm increments. The N component is determined by the location of infiltrated lymph nodes. The M component is subdivided into intrathoracic dissemination, a single extrathoracic metastasis and many metastases.
The implementation of the 8th Edition was delayed to January 1, 2018. Since there is not yet validated by large clinical series, this chapter is still based on the previous 7th Edition. Concerning imaging what seems more important is the accurate tumor size measurement and the correct evaluation of the number of metastatic sites.
CT and MRI imaging are considered as useful for precise assessment of tumor extent. Additionally, CT is helpful in guiding invasive biopsy procedures. MRI is the noninvasive procedure of choice in the evaluation of superior sulcus tumors and those lesions with suspected vascular, pericardial, or cardiac invasion. MRI is also complementary to CT in the evaluation of chest wall invasion and distant metastases.
NSCLC Diagnosis Staging CT MRI
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