Abstract
The management of lung cancer patients requires a definitive diagnosis and a precise assessment of the disease extent. Pathological examination performed on tissue or cytological samples taken from the tumor, associated lymphadenopathy or an accessible metastatic site answers the first question while a set of staging techniques ensures the second. Guidelines for each technique have been issued in order to maximize diagnostic yield and allow immunohistochemical and molecular biology analyzes which impact the therapeutic strategy. The aim of this article is to discuss the different diagnostic and staging methods and to propose solutions for optimizing the diagnosis and the assessment of the anatomic extent of lung cancers. In this context, the indications and limits of the different modalities are discussed. The size of the tumor, its pleural, parietal, endobronchial and direct mediastinal extension must be specified as well as lymph node and distant extension. The clinical examination remains essential. Contrast enhanced Chest CT is systematic, unless contraindicated. 18FDG PET-CT is not always indicated but is essential in patients potentially eligible for curative treatment. Brain imaging is indicated, even in asymptomatic patients. Compliance with recommendations and adequate organization optimize patient care.1877-1203/© 2024 SPLF. Published by Elsevier Masson SAS. All rights reserved.
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