Reporting Lung Cancer

Lung cancer is the third most common cancer in the UK, with around 48,500 new cases diagnosed per year. Incidence is decreasing, having decreased by around nine percent since the 1990s, though this includes an increase in females and a decrease in males. Lung cancer incidence rates are projected to fall by 2% in the UK between 2023-2025 and 2038-2040.

PET-CT Scans Performed 2022-2023

At our institution, lung cancer accounts for 37% of all PET-CT scans performed.

The evidence-based indications for use of PET-CT in the UK 2016 list five indications for FDG PET CT in lung cancer.

1. Staging of patients considered for radical treatment of non-small cell lung cancer
2. Characterisation of a solid solitary pulmonary nodule with an initial risk of malignancy of 10% (Brock model)
3. Assessment of response to chemotherapy and/or radiation treatment in selected patients
4.  Assessment of suspected disease recurrence
5. Staging of patients with small-cell lung cancer

The use of PET-CT in these indications will be studied in detail in this course, which is comprised of four modules, followed by a case-based assessment.

• Tutorial 1: Anatomy, tracer distribution and the rationale for imaging
• Tutorial 2: Primary tumour assessment (T-Staging) 
• Tutorial 3: Staging of lung cancer 
• Tutorial 4: Radiotherapy planning, response assessment, and detection 

Learning Objectives

• Describe the relevant radiological anatomy of the thorax, lung segmental and pleural anatomy
• Discuss the variable patterns of FDG uptake associated with lung cancers and the rationale for the use of PET-CT
• Discuss the use of PET-CT in T-Staging including ambiguities in staging
• Identify the role of PET-CT in treatment response

Suitable for radiologists and nuclear medicine physicians who intend to train to report PET-CT, or who otherwise encounter these studies in their practice and wish to increase their confidence, for example in the role of a presenting radiologist at an MDT (Multi-Disciplinary Team).

Please note: To mark this course as complete on your Learning Dashboard and access your certificate of completion, you must finish all learning modules and submit the course evaluation.

References:

1. Evidence-based indications for the use of PET-CT in the United Kingdom 2022
2. Cancer Research UK. Accessed November 2023.