Metastatic involvement (M) M0 - No metastases

M1 - Metastases present

Metastases (M) M0: No distant metastasis M1: Distant metastasis present; or Separate tumor nodules in the

ipsilateral nonprimary-tumor lobes of the lung. Separate tumor nodules in the contralateral lung are considered M1 if they are of the same histologic cell type as the primary lesion. A contralateral lung tumor with a different cell type is considered a synchronous primary lesion and should be staged independently

Stage Tumor Nodes Metastases

Stage 0   

TIS- Carcinoma in situ    

IA  IB   

T1  T2   

N0  N0   

M0  M0   

IIA  IIB   

T1  T2  T3   

N1  N1  N0   

M0  M0  M0   

IIIAT1 or T2  T3   

N2  N1 or N2   

M0  M0   

IIIBAny T  T4   

N3  Any N   

M0  M0   

IV   

Any T Any N M1

Advantages MRI has over CT in Tumor assessment Mediastinal and chest wall invasion and

involvement of the diaphragm.MRI is most useful when evaluating spinal

cord compression and brain metastasis . In Pancoast tumours, invasion into the

brachial plexus, subclavian artery or vertebral body by MRI has been found to be 94% accurate as opposed to 63% for CT .

Positron Emission TomographyPET scans appear to be more sensitive,

specific, and accurate than CT scans for staging mediastinal disease.

PET is more accurate than conventional studies in detecting recurrent lung cancer.

False-positive studies do occur secondary to postirradiation inflammatory change and delaying the examination until 4 or 5 weeks postirradiation is recommended

The solitary pulmonary noduleA common incidental CXR finding .CT detects many more lung nodules than

CXR. Numerous differential diagnoses. 50% are malignant: 40% are primary CA,

10% are solitary metastases .Prompt diagnosis and management of

early lung cancer manifesting as SPN may be the only chance for cure.

No significant mortality reduction with screening.

Calcification in SPNCT scanning can further refine the detection

of calcification and fat within nodules. A total 22–38% of noncalcified nodules on chest radiographs appear calcified on CT.

Eccentric or stippled calcification is seen in 10% of lung cancers.

Features of SPN suggesting benignityClinical history, especially of T.B. Compared with old films, no growth over a 2-

yr period.Age <35 yrs,No history of cigarette smoking.No history of extrathoracic malignancy .

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