Diagnosing Lung Cancer

Determining the specific type of lung cancer — and its stage — helps the care team plan the most effective treatment approach. Our lung cancer specialists use a variety of tools and techniques to diagnose lung cancer, including:

• Dual-energy chest X-rays can find tumors that may be hidden behind bones when viewed in traditional X-rays.
• Computed tomography (CT), using a 256-slice scanner, creates hundreds of one-millimeter-thin “pictures” inside the chest to reveal very small lung cancers.
• Positron emission tomography (PET) looks at the metabolism of the tissue. This is important because cancer cells use sugar, or metabolize, faster than normal cells. PET can be particularly helpful when staging cancer to see if it has spread.
• Peripheral bronchoscopy, using the superDimension system, builds a 3-D roadmap of the patient’s lungs, pointing with accuracy to spots in the lung that can’t normally be reached by scopes. This is an outpatient procedure that involves no cutting. Visit the manufacturer's website to view a video about a superDimension procedure that features UChicago Medicine pulmonologist D. Kyle Hogarth, MD.
• Endobronchial ultrasound (EBUS), stages lung cancer without the need for surgery. Now through a simple outpatient procedure, all the lymph nodes can be sampled to prove whether or not cancer has spread. This also allows doctors to resample known cancers in a safe and simple way to evaluate for mutations that could be treated with targeted chemotherapies.
• Tissue samples taken during a biopsy procedure are sent to our pathologists who specialize in studying and analyzing cells under a microscope to determine the presence of lung cancer. Analysis of the type and stage of lung cancer assists the care team in choosing the best treatment approach for each patient.
• Genetic testing is done to screen for genetic changes, or mutations, which can drive a cell to become cancerous or cause cancer to spread. Our molecular pathology lab searches across more than 1,000 genes to screen for mutations. The most common mutations related to lung cancer are seen in the genes EGFR, KRAS and ALK. By including this important diagnostic step, therapy can then be matched, or targeted to, the specific genetic changes in each tumor. Only a few centers in the country offer this type of personalized medicine for non-small cell lung cancer.