skip to main content
RadInfo Logo Home

Noninvasive Clinical Staging of Primary Lung Cancer

Lung cancer is the leading cause of cancer-related deaths in both men and women in the United States. The major cause of lung cancer is cigarette smoking, but other risks include exposure to secondhand smoke, environmental radon, occupational exposures, and air pollution.

There are two main forms of lung cancer: non–small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). NSCLC is the most common cancer and accounts for approximately 85% of cases, and SCLC accounts for approximately 15%. Staging determines the extent that the cancer has grown and spread. Numbers from 0 to 4 (I, II, III, IV) refer to how far the cancer has spread, with stage IV being the most advanced stage.

Usually, appropriate imaging tests for the staging of NSCLC are an initial CT chest with intravenous (IV) contrast or without IV contrast followed by FDG-PET/CT skull base to mid-thigh (uses IV radioactive sugar to find metabolic activity in cancer cells) and MRI head without/with IV contrast (to look for cancer spread to the brain) which are obtained based on the initial CT chest and other test results. CT head, CT abdomen/pelvis, MRI chest, MRI abdomen, and whole-body bone scan may be appropriate depending on the situation. Similarly, to stage SCLC, CT chest with IV contrast, FDG-PET/CT skull base to mid-thigh, MRI head without/with IV contrast, and CT abdomen/pelvis with IV contrast are usually appropriate. CT head, CT abdomen/pelvis, MRI chest, MRI abdomen, and whole-body bone scan may be appropriate.

For more information, visit the Lung Cancer page.

— By Elle Sutherland and Gregory J. Czuczman, MD. This information originally appeared in the Journal of the American College of Radiology.

This page was reviewed on January 24, 2024

Sponsored By

Please note

RadiologyInfo.org is not a medical facility. Please contact your physician with specific medical questions or for a referral to a radiologist or other physician. To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database.

This website does not provide cost information. The costs for specific medical imaging tests, treatments and procedures may vary by geographic region. Discuss the fees associated with your prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a better understanding of the possible charges you will incur.

Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the Radiological Society of North America (RSNA) and the American College of Radiology (ACR), comprising physicians with expertise in several radiologic areas.

Outside links: For the convenience of our users, RadiologyInfo.org provides links to relevant websites. RadiologyInfo.org, RSNA and ACR are not responsible for the content contained on the web pages found at these links.