Lung Cancer, Screening & Early Detection
- Screening & Early Detection
- Medical Oncology
The Role of CT
The above image shows a lung nodule in a screening CT scan requested by the patient, a 69-year-old former smoker.
Compelling evidence from several sources now suggests that in high-risk individuals, CT (computed tomography or CAT) screening is the best method to detect lung cancer in its earliest stage. The majority of lung cancers originate as a small growth or nodule in the lung. Screening CT scans are extremely sensitive in detecting nodules as small as 2 or 3mm within the lungs—much smaller than can be viewed on a conventional chest Xray. In fact, recently published articles on CT screening found that the majority of lung cancers that revealed on CT scanning could not be detected on a chest X-ray that was performed simultaneously.
The Role of PET (Positron Emission Tomography)
Early lung cancer detection at NewYork-Presbyterian/Columbia benefits greatly from its affiliation with the Columbia Kreitchman PET Center, one of the nation's foremost clinical and research PET (positron emission tomography) and PET/CT facilities.
PET is powerful, non-invasive, diagnostic tool that detects biochemical changes in body tissues. To feed their rapid growth, tumors consume more glucose than healthy tissues. The PET scanner, which creates a color-coded image of the body's chemical function reveals the cancer as red "hot spots" of activity.
PET/CT is the combination of PET and CT imaging techniques within a single machine. The individual PET and CT scans are taken concurrently while the patient remains in place, and can be presented separately or as a single, overlapping, "fused" image.
The two techniques present different types of information about the human body: while PET shows chemical activity, CT shows anatomical structures. For example, a PET scan would highlight a tumor's increased glucose consumption, while a CT scan would reveal its physical mass. The fused PET/CT image provides a more reliable alternative to the traditional side-by-side visual comparison of PET and CT images.
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| The CT image (left) shows a mass in the left lung. The combined PET/CT image (right) reveals the metabolic activity of that mass, as well as its precise location in the lung. The fused image can help physicians with diagnosing and staging the disease, as well as tailoring the treatment plan. Images courtesy of Siemens. | |
We have used PET and PET/CT scanning in thousands of patients with lung cancer, to determine whether lung nodules are benign or malignant. Incorporating PET scanning in this way often can guide treatment plans—from indicating whether a biopsy is necessary, to guiding the shape of the area to receive radiation therapy, to pinpointing the surgical site.
