The detection, evaluation, staging, and therapy of lung cancer remain major challenges in 2011, yet strides have certainly been made since the Journal's last symposium on this topic in 1999.1 In this issue, we not only revisit this subject but also discuss advances in our understanding over the past decade.
A review of lung nodules2 by Drs Scott Brandman and Jane P. Ko from New York University School of Medicine provides an update on new technologies pertaining to the detection and characterization of these lesions. Clinical decision making and management are also discussed.
Drs Ho Yun Lee and Kyung Soo Lee from Samsung Medical Center provide a review of radiological–pathological correlation pertaining to ground-glass nodules and lung cancer.3 The authors address advances in computed tomography (CT) that have improved awareness and assessment of these clinically significant entities, as well as the implications of CT characteristics.
Next, an article by Dr Susan Greaves from South Manchester University Hospital NHS Trust and coauthors from the University of California Los Angeles and University of Southern California outlines the new TNM staging system for lung cancer, which was recently revised by the International Association for the Study of Lung Cancer.4 The updated staging system provides improved prognostic stratification of lung cancer patients and has recently been adopted by major lung cancer organizations.
Dr Mylene Truong et al5 from University of Texas MD Anderson Cancer Center summarize the use of positron-emission tomography/CT in the diagnosis and staging of lung cancer. They also discuss current roles for positron-emission tomography/CT in the assessment of prognosis and response to therapy.
An article on endoscopic and endobronchial fine-needle aspiration by Dr Barbara McComb and colleagues6 from the Mayo Clinic Florida reviews the efficacy of these minimally-invasive procedures in lung cancer diagnosis and staging. The techniques are elucidated along with clinical studies and potential future roles.
Therapeutic methods related to transthoracic interventional therapy7 are covered through the collaborative efforts of Drs Amita Sharma and Jo-Anne Shepard of Massachusetts General Hospital and Dr William Moore of Stony Brook Medical Center. Their “How I Do It” manuscript examines the selection, preparation, and follow-up of patients undergoing interventional therapy.
Finally, Dr Jessica Donington and coauthors8 from New York University School of Medicine provide a clinical perspective on novel approaches to lung cancer treatment. These authors address emerging options such as limited resection techniques, targeted therapies, and genetic profiling that now permit some lung cancer patients to undergo more personalized treatments than in past years.
Complementing the above manuscripts are editorials devoted to timely topics pertaining to lung cancer. Dr Charles White9 from the University of Maryland has contributed a perspective on lung cancer screening. Dr John Austin10 from Columbia University Medical Center has submitted an editorial on the challenges presented by the management of pulmonary nodules and the state of clinical guidelines for these findings.
Through this symposium, the reader will gain insight into progress that has been made in the diagnosis and treatment of lung cancer over the past decade, not only in the realm of imaging advances but also in the spheres of pathology and therapeutic intervention. In addition, the reader should achieve an increased awareness of those questions that yet remain unanswered and toward which future investigations will certainly be directed.
We extend our gratitude to all of the authors who contributed their precious time and efforts to developing this symposium, and to Phil Boiselle, Editor-in-Chief of the Journal of Thoracic Imaging, for providing us the opportunity to serve as guest editors. In addition, we thank the Journal of Thoracic Imaging editorial and publishing teams for their attention to detail, our colleagues for their advice and guidance, and our families for their patience and steadfast support.
1. Patz EF. From the Guest Editor J Thorac Imaging.. 1999;14:227
2. Brandman S, Ko JP. Pulmonary nodule detection, characterization and management with MDCT J Thorac Imaging.. 2011;26:90–105
3. Lee HY, Lee KS. Ground-glass opacity nodules: histopathology, imaging evaluation, and clinical implications J Thorac Imaging.. 2011;26:106–118
4. Greaves S, Brown K, Garon EB, et al. The new staging system for lung cancer: imaging and clinical implications J Thorac Imaging.. 2011;26:119–131
5. Truong MT, Viswanathan C, Erasmus JJ. PET/CT in lung cancer staging, prognosis and assessment of therapeutic response J Thorac Imaging.. 2011;26:132–146
6. McComb BL, Wallace MB, Pascual JM, et al. Mediastinal staging of non-small cell lung carcinoma by endoscopic and ednobronchial ustrasound-guided fine needle aspiration J Thorac Imaging.. 2011;26:147–161
7. Sharma A, Moore WH, Lanuti M, et al. How I do it: radiofrequency ablation and cryoablation of lung tumors J Thorac Imaging.. 2011;26:162–174
8. Donington J, Koo CW, Ballas MS. Novel therapies in lung cancer J Thorac Imaging.. 2011;26:175–185
9. White CW. National Lung Screening Trial: A Breakthrough in Lung Cancer Screening? J Thorac Imaging.. 2011;26:86–87
10. Austin JHM. The incidental small pulmonary nodule and the Fleischner criteria five years later: have we learned anything more? J Thorac Imaging.. 2011;26:88–89