Radiological and "imaging" methods in TNM classification of non-small-cell lung cancer

Lung cancer is the most common worldwide malignant disease according to its incidence and mortality. The aim of our study was to evaluate the diagnostic value of the radiological and imaging methods, according to the TNM classification, compared to postoperative histological diagnosis. Thirty-seven patients with pulmonary carcinoma were studied prospectively using native chest radiography (PA and LL view), computed tomography (CT) and magnetic resonance imaging (MRI) during ten days before thoracotomy. Radiological and imaging findings were reviewed separately and results were compared with surgical and pathohistological findings on the basis of the TNM classification. All patients underwent chest x-rays, CT was performed in 36 patients and MRI in 12 of them. Imaging methods (CT and MRI) showed more accuracy in sensitivity and specificity compared with the native chest radiography in a great percentage. Generally no statistically significant differences were found between the two imaging methods for the evaluation of tumour extent (T) or lymph node metastases (N). MRI was slightly superior to CT in determination of the chest wall extent of the tumour. In conclusion CT remains the imaging modality of choice both for assessing patients with abnormal chest radiographs suspected of having lung cancer, and in staging patients with histologically proven pulmonary carcinoma.