Letter From the Guest Editor: Lung Cancer

Article Outline

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This issue of Seminars in Roentgenology, dedicated to lung cancer compiles a selection of articles by experts in this disease. Lung cancer remains the most common cause of cancer related deaths worldwide.

Dr. McErlean and I provide an overview of incidence, mortality, risk factors and new molecular profiling of lung cancer. Identification of EGFR and KRAS mutations in lung tumors has been a major advance in the understanding of lung cancer biology, facilitating development of targeted therapies and in providing prognostic predictors of treatment response and outcome.

Dr. Travis from Memorial Sloan-Kettering Cancer Center discusses the new lung adenocarcinoma classification developed by an international multidisciplinary panel including pathologists, molecular biologists, oncologists, radiologists and thoracic surgeons which will result in significant changes in the 2004 WHO Classification. For the first time in the history of lung cancer new terminology has been proposed for classification of lung cancer in small biopsies and cytology.

Drs. Carson and Finley from the thoracic surgical service at Memorial Sloan-Kettering Cancer Center review the historical perspective of the TNM staging system. They discuss specific changes addressed by the AJCC 7^th edition new TNM lung cancer staging system and the implications for radiographic clinical staging.

Drs. Kligerman and White from the University of Maryland discuss imaging characteristic of various histologies of lung cancer and certain findings that may help suggest as specific cell type.

Dr. DeLappe and Dunphy of the nuclear medicine service at Memorial Sloan-Kettering Cancer Center review FDG-PET imaging in lung cancer staging, which is now a vital part of staging patients with lung cancer.

Treatment of lung cancer with radiofrequency ablation is a new recognized modality for treatment of early stage tumors in patients who are not surgical candidates and as adjunctive salvage therapy. It also plays a role in treatment of lung metastases and palliation of painful chest wall masses. These treatment options are discussed by Drs. Pua, Thornton and, Solomon of the Interventional Radiology Service at Memorial Sloan-Kettering Cancer Center.

Results of the National Lung Screening Trial (NLST) reported in November 2010 demonstrated a 20% reduction in lung cancer mortality in the computed tomography arm of its randomized controlled trial. Dr. Chiles discusses the results of this trial as well as principles of screening and historical data of prior lung cancer screening programs.

Imaging of lung cancer plays a vital role in the detection, staging and treatment assessment of lung cancer. Interventional radiologists are more involved in the treatment of nonsurgical candidates or palliative treatment of lung tumors. The recent results of the NLST lung screening trial will likely lead to new guidelines for screening of this deadly disease.

On behalf of our readers, I thank the authors for their important contributions to this special issue dedicate to lung cancer.