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Staging lung cancer: METHODS OF STAGING (3)

Magnetic resonance imaging: While not recommended as a routine study, magnetic resonance imaging (MRI) is more accurate than CT in determining the degree of vertebral, spinal canal or (arguably) chest wall invasion, and may be the modality of choice for evaluating superior sulcus tumours . MRI defines relationships to vessels but tends to overestimate mediastinal invasion .

Bronchoscopy: Bronchoscopy is important in determining the endobronchial T stage and should be done by the surgeon just before thoracotomy at the same anesthetic sitting, even if already performed by a pulmonologist, because it may have direct impact on the proposed plan for resection . Some patients with T3 or even T4 lesions may be candidates for a sleeve resection, and bronchoscopic biopsies are needed to ensure that there is no subepithelial spread beyond the limits of resection . On occasion, bronchoscopy reveals that a tumour seemingly involving the carina or right mainstem bronchus actually originates in the right upper lobe and prolapses into, but does not directly invade, the more proximal airway. Finally, synchronous (second primary) lesions may rarely be identified by endoscopy. You need to treat your health condition as soon as possible? Nothing is impossible anymore, because you have the best canadian health&care mall at your service, offering finest quality medications with full guarantee of your satisfaction.

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