Diagnostic evaluation of lung cancer

Lung cancer is the fourth rate cause of death in Germany. Symptoms are mainly unspecific and develop lately. Clinical history and examination come in first place of the diagnostic procedure. X-ray of the thorax is the basis of imaging and is completed by a CT scan of the chest. Afterwards, a biopsy for histological or cytological evaluation should be performed by the least invasive method, mostly bronchoscopy. Supplemented by modern techniques as narrow-band-imaging, endobronchial ultrasound and electromagnetic navigation, bronchoscopy takes a high value in the diagnostic procedure. Further staging is performed depending upon individual therapeutic options. Positron-emission-tomography has good evidence in lung cancer. On the one hand it serves for further evaluation of mediastinal lymphadenopathy and on the other it can complete extrathoracical staging. This should comprise the most prevalent localizations of metastasis, the adrenal glands, liver, and bones, while especially the brain should be imaged with usage of magnet resonance imaging.