What are the limitations of CT scanning for the staging of non-small cell lung cancer (NSCLC)?

Updated: Aug 27, 2019
  • Author: Sat Sharma, MD, FRCPC; Chief Editor: Eugene C Lin, MD  more...
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Normal-sized lymph nodes have been reported in 7-33% of patients undergoing CT staging. In addition, controversy exists over whether the short-axis or the long-axis diameters should be used in imaging. Another limitation may be interobserver variability in the interpretation of imaging studies. Despite the limitations, CT provides useful staging information to the surgeon. Noting enlargement in a specific location may help surgeons plan procedures, including mediastinoscopy, mediastinotomy, or percutaneous needle aspiration biopsy.

CT is useful in demonstrating extrathoracic metastases. Distant metastases demonstrated with CT include metastases to the adrenal glands, brain, bones, liver, and soft tissues.

Chest CT should include the upper abdomen to assess the liver, upper abdominal lymph nodes, and adrenal glands. However, on needle biopsy, most adrenal masses are shown to be adenomas rather than metastases.

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