Lung Cancer

Despite the worldwide drive to increase awareness of the risks of smoking, lung cancer remains a global problem.

A multidisciplinary team approach is now considered the most effective way to manage lung cancer. Imaging plays a central role in this multidisciplinary approach; this is reflected in the present volume.

Individual chapters focus on imaging (including screening, diagnosis of symptomatic cases and staging) pathology and treatment options in lung cancer. Due to recent interest in the potential role of PET for a variety of malignancies, a separate chapter is devoted to this technique.

Each volume in Contemporary Issues in Cancer Imaging is coordinated by an expert guest editor with contributions from all members of the multidisciplinary team, bringing together expertise from many specialties to promote the understanding and application of modern imaging in patient management.

Sujal R. Desai is a Consultant Radiologist at King's College Hospital, London.

Contemporary Issues in Cancer Imaging

A Multidisciplinary Approach

Series Editors

Rodney Reznek
Cancer Imaging, St Bartholomew's Hospital, London

Janet Husband
Diagnostic Radiology, Royal Marsden Hospital, Surrey

Lung Cancer

---

Sujal R. Desai

CAMBRIDGE UNIVERSITY PRESS
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo

Cambridge University Press
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Published in the United States of America by Cambridge University Press, New York

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Information on this title: www.cambridge.org/9780521872027

© Cambridge University Press 2007

This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press.

First published 2007

Printed in the United Kingdom at the University Press, Cambridge

A catalogue record for this publication is available from the British Library

Library of Congress Cataloging-in-Publication data

Lung cancer / [edited by] Sujal Desai.
  p. ; cm. -- (Contemporary issues in cancer imaging)
 Includes bibliographical references and index.
 ISBN-13: 978-0-521-87202-7 (hardback)
 1. Lungs–Cancer. I. Desai, Sujal, 1962-II. Series.
 [DNLM: 1. Lung Neoplasms. WF 658 L96065 2006] I. Title. II. Series.

 RC280.L8L76535 2006
 616.99'424--dc22
                                 2006031970

ISBN-13 978-0-521-87202-7 hardback
ISBN-10 0-521-87202-2 hardback

Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party Internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

Contents

Contributors

Shahreen Ahmad, B.SC., M.B.B.S., M.R.C.P., F.R.C.R.
Guy's, King's and St Thomas’ Joint Cancer Centre
Department of Clinical Oncology
St Thomas’ Hospital
London, UK

Zelena A. Aziz,
Department of Radiology
St Bartholomew's and the Royal London Hospital
London, UK

Andrew Chukwuemeka, M.D., F.R.C.S.
SELCN Lead for Lung Cancer Research
Guy's, King's and St Thomas’ Cancer Centre
London, UK

Gary. J. R. Cook, F.R.C.R., F.R.C.P.
Department of Nuclear Medicine and PET
Royal Marsden Hospital
Sutton
Surrey, UK

Sarah. J. Copley, M.D., M.R.C.P., F.R.C.R.
Department of Radiology
Hammersmith Hospital
London, UK

Thomas E. Hartman, M.D.
Department of Radiology
Mayo Clinic
Rochester, MN, USA

Sayed A. M. Z. Jafri, M.B.B.S., M.R.C.S.
Department of Radiology
Hammersmith Hospital
London, UK

Thomas. B. Lynch, F.R.C.P.
Department of Nuclear Medicine and PET
Royal Marsden Hospital
Sutton
Surrey, UK

Michael T. Marrinan, F.R.C.S.ED.
SELCN Lead for Lung Cancer Research
Guy's, King's and St Thomas’ Cancer Centre
London, UK

Sabine Pomplun, M.SC., M.D., M.R.C. PATH
Department of Histopathology
King's College Hospital
London, UK

Joseph Prendiville, PH.D., MB., B.C., B.A.O., F.R.C.P.
SELCN Lead for Lung Cancer Research
Guy's, King's and St Thomas’ Cancer Centre
London, UK

Alistair Ring, M.A., B.M., B.CL., M.R.C.P., M.D.
SELCN Lead for Lung Cancer Research
Guy's, King's and St Thomas’ Cancer Centre
London, UK

Pallav Shah, M.D., F.R.C.P.
Royal Brompton Hospital
London, UK

Series Foreword

Imaging has become pivotal in all aspects of the management of patients with cancer. At the same time it is acknowledged that optimal patient care is best achieved by a multidisciplinary team approach. The explosion of technological developments in imaging over the past years has meant that all members of the multidisciplinary team should understand the potential applications, limitations and advantages of all the evolving and exciting imaging techniques. Equally, to understand the significance of the imaging findings and to contribute actively to management decisions and to the development of new clinical applications for imaging, it is critical that the radiologist should have sufficient background knowledge of different tumours. Thus the radiologist should understand the pathology, the clinical background, the therapeutic options and prognostic indicators of malignancy.

Contemporary Issues in Cancer Imaging – A Multidisciplinary Approach aims to meet the growing requirement for radiologists to have detailed knowledge of the individual tumours in which they are involved in making management decisions. A series of single subject issues, each of which will be dedicated to a single tumour site, edited by recognized expert guest editors, will include contributions from basic scientists, pathologists, surgeons, oncologists, radiologists and others.

While the series is written predominantly for the radiologist, it is hoped that individual issues will contain sufficient varied information to be of interest to all medical disciplines and to other health professionals managing patients with cancer. As with imaging, advances have occurred in all these disciplines related to cancer management and it is our fervent hope that this series, bringing together expertise from such a range of related specialities, will not only promote the understanding and rational application of modern imaging but will also help to achieve the ultimate goal of improving outcomes of patients with cancer.

Rodney Reznek
London

Janet Husband
London

Introduction

In the United Kingdom well over 30,000 new cases of lung cancer are diagnosed each year and there are a roughly similar number of deaths attibutable to the disease annually. In recent years there has been a paradigm shift in emphasis in the management of patients with lung cancer: a ‘team approach’ is now considered most appropriate and most institutions now have dedicated groups of multidisciplinary specialists who contribute to clinical management. This multidisciplinary approach is reflected in the present volume dedicated to lung cancer. Individual chapters focus on the clinical aspects, pathology, radiology (including screening, diagnosis of symptomatic cases and staging) and treatment options in lung cancer. Because of the recent interest in the potential role of positron emission tomography for a variety of malignancies, a separate chapter is devoted to this technique. Whilst the volume is primarily directed at radiologists, it is hoped that the volume will also be of value to other medical specialists who regularly manage patients with lung cancer.

Sujal R. Desai