[Computed tomography imaging of non-small cell lung cancer]

Computed tomography (CT) plays a key role in the initial evaluation of non-small cell lung cancer. It allows initial staging and helps targeting lesions for pathological analysis. The aim of initial imaging work-up is to differentiate between localized disease, eligible to a local treatment, and advanced disease requiring medical treatment. CT is very useful for the assessment of local extension but is less accurate than positron emission tomography (PET)-CT for the assessment of lymphatic and metastatic spread. However, initial staging should include CT examination of the brain and upper abdomen, and PET-CT should be only be performed in patients eligible to a local treatment after initial CT assessment. Propositions for the 8th edition of lung cancer TNM bring several changes for T staging. In particular, the weight of lesion size is increased. Similarly, N1 and N2 stages are now divided in subgroups according the number of involved stations.