What are the guidelines on imaging for small cell lung cancer (SCLC)?

Updated: Sep 12, 2019
  • Author: Abid Irshad, MD; Chief Editor: Eugene C Lin, MD  more...
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According to the American College of Radiology (ACR) Appropriateness Criteria, chest CT with IV contrast and MRI without and with IV contrast are usually appropriate for the noninvasive initial clinical staging of SCLC. FDG PET/CT from skull base to mid-thigh or abdominal or pelvic CT with IV contrast is usually appropriate; however, FDG-PET/CT is found to be more sensitive for lymph node and adrenal metastases, and it is superior to CT for bone marrow metastases. [15]  

The National Comprehensive Cancer Network (NCCN) guidelines recommend CT scan with IV contrast of the chest/abdomen and brain imaging using MRI (preferred) or CT scan with IV contrast for staging of SCLC. If limited-stage disease is suspected, a PET/CT scan from skull base to mid-thigh can be performed to assess for distant metastases. A bone scan can be considered if PET/CT is equivocal or not available. [16]

The European Society of Medical Oncology (ESMO) recommends the following [6] :

  • A CT scan with contrast of the chest and abdomen.
  • In localized disease or if symptoms or clinical findings suggest involvement, additional bone scintigraphy and CT or MRI of the brain.
  • FDG-PET CT is optional in localized disease. PET findings, which modify treatment decisions, should be pathologically confirmed.

Additional guidelines on SCLC and NSCLC have been published by ESMO, ACS, ACR, ASCO, ACCP, ASCO, NCI, USPSTF, and NCCN. [15, 16, 6, 7, 17, 13, 18, 19]

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