Lung Cancer Diagnosis

A CT (or CAT) scan is a special kind of X-ray that takes many pictures while you lie on a table that slides in and out of the machine. A computer then combines these pictures into a detailed picture of the part of your body that was scanned. CT scans are often used to evaluate abnormalities seen on a chest X-ray or to further examine a lung nodule or mass. 

Learn more about CT scan.

For a PET scan, a form of radioactive sugar isotope is injected into the blood. Cancer cells in the body absorb large amounts of the sugar. A special camera can then detect the radioactivity. This test can help find out whether the cancer has spread to the lymph nodes or other parts of the body. PET scans can help identify areas that may contain cancer, but additional testing or biopsy is often needed to confirm the findings. 

A lighted, flexible tube (called a bronchoscope) is passed through the mouth or nose and into the large airways of the lungs. This test can help the doctor see tumors, or it can be used to take samples of tissue to see if cancer cells are present.

Learn more about bronchoscopy.

EBUS is a procedure that takes place during a bronchoscopy. It is commonly used to obtain tissue samples from lymph nodes and structures in the chest and is an important tool for diagnosing and staging lung cancerBronchoscopy is a procedure to look directly at the airways in the lungs using a thin, lighted tube (bronchoscope). In an EBUS procedure, the bronchoscope is fitted with an ultrasound device (a device that uses sound waves to make pictures of the inside of your body) at its tip. It is passed down into the windpipe to look at nearby lymph nodes and other structures in the chest. This is done with numbing medicine (local anesthesia) and sedation. A hollow needle can be passed through the bronchoscope and guided by ultrasound into an area of concern to take biopsy samples, which is called EBUS-TBNA. It stands for Endobronchial ultrasound-guided transbronchial needle aspiration.

Learn more about EBUS.

This test is much like an endobronchial ultrasound (EBUS), except that it is usually performed with the intent to look at the digestive tract, instead of just the airways. When used during the lung cancer diagnostic process, its purpose is to help physicians examine a certain part of the space between the lungs in the chest (the mediastinum) and surrounding lymph nodes. In this procedure, an endoscope (a lighted, flexible tube) fitted with an ultrasound device is passed down the throat and into the esophagus and used as a guide for physicians to view and sample (biopsy) structures and tissue.

Advanced bronchoscopy techniques may be used to help physicians reach small or difficult-to-access lung nodules and obtain biopsy samples. These procedures use specialized imaging and navigation technology to guide the bronchoscope to areas of concern identified on imaging studies. 

Both of these tests let the surgeon look at and take samples of lymph nodes in the area between the lungs (this area is called the mediastinum).

This test is done to check whether fluid around the lungs is caused by cancer or by some other medical problem. A needle is placed between the ribs to drain the fluid. The fluid is checked for cancer cells.

In this procedure, a small cut is made in the chest. The surgeon then uses a thin, lighted tube connected to a video camera and screen to look at the space between the lungs and the chest wall. The surgeon can see small tumors on the lung or lining of the chest wall and can take out pieces of tissue to be looked at under the microscope. Thoracoscopy and video-assisted thoracic surgery (VATS) can also be used as part of the treatment to remove part of a lung in some lung cancers.

A sample of mucus you cough up from the lungs (called sputum or phlegm) is examined under a microscope to see if cancer cells are present. Although used less often than other diagnostic procedures, sputum cytology may sometimes help detect cancer cells that are shed into the airways.

A long, thin (fine) needle is used to remove a sample of cells from the area that may be cancer. The sample is examined in the lab to see if it contains cancer cells.

Under general anesthesia an incision is made in the chest, between the ribs, to obtain a tissue sample or to remove the cancer. Open biopsy may be performed when minimally invasive procedures cannot provide enough tissue during diagnosis. 

In some cases, your healthcare team may also order a blood test called a liquid biopsy. This test looks for tumor DNA circulating in the bloodstream and may help identify biomarkers that can guide treatment decisions. A liquid biopsy does not replace a tissue biopsy for diagnosis but may provide additional information.