To review and describe the major changes included in the most recent version (7th edition) of the TNM staging system for NSCLC, as compared with the sixth edition, which was replaced as of January 1, 2010. To highlight and emphasize the role of imaging techniques (CT, PET, PET-CT and MRI) in the staging and follow-up of NSCLC.

The Tumor-Node-Metastasis (TNM) staging system for non-small cell lung cancer (NSCLC, accounting for the 87% of all lung cancers) is an internationally accepted system used to determine the disease stage. This disease stage is a measure of the extent of disease, which is used to guide the clinical-diagnostic stage, surgical-pathologic stage, retreatment stage, autopsy stage and prognosis. The TNM staging system for NSCLC categorizes tumors on the basis of primary tumor characteristics (T), the presence or absence of regional lymph node involvement (N), and the...

We describe and illustrate the role of imaging techniques (computed tomography -CT-, whole body positron emission tomography -PET-, integrated PET-CT and magnetic resonance imaging -MRI-) in the diagnosis, staging and follow-up of NSCLC, highlighting their indications, limitations, and complementary function in oncologic imaging. IMAGINGTECHNIQUES All patients with suspected NSCLC should have a history and physical examination performed, as well as laboratory testing and imaging techniques. Imaging aims to accomplish three goals: a) determine the disease stage; b) identify lesions that warrant tissue sampling; and c)...

Major changes in the most recent version of the TNM staging system for NSCLC are reviewed and illustrated, with a particular emphasis on the role of different imaging modalities in the oncologic work-flow. Radiolo­gists must understand the details set forth in the TNM classification system and be familiar with the changes in the 7th edition, which at­tempts to better correlate disease with prognostic value and treatment strategy. By recognizing the relevant radiologic appearances of lung can­cer, understanding the appropriateness of staging disease with the TNM...

Raquel Cano Alonso is a staff-radiologist at Hospital Universitario Quirón Madrid (Spain). Her main research interest includes oncologic-imaging and neuro-radiology, and has authored several articles in the recent literature. She studied at the Universidad Complutense de Madrid, where she graduated in Medicine in 2004, and completed her residency in radiology at Hospital Universitario Doce de Octubre (Madrid, Spain) in 2009. She is a member of the Sociedad Española de Radiología Médica (SERAM) and the European Society of Radiology (ESR).

Erasmus JJ, Truong MT, Munden RF.CT, MR, and PET imaging in staging of non-small-cell lung cancer. Semin Roentgenol. 2005;40:126-42 AJCC Cancer Staging Manual, 6th ed, Greene, FL, Page, DL, Fleming, ID, et al (Eds), Springer-Verlag, New York 2002. p. 435. UICC TNM Classification of Malignant Tumors, 6th Ed, Sobin, L, Wittekind, C (Eds), Wiley-Liss, New York 2002. p. 272. Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the...