NCCN Guidelines for Patients
: Non-Small Cell Lung Cancer
Part 5: Tests by cancer stage
5.1 Pulmonary function tests
I, II, III, and IV tumors
that may be treated with
surgery or radiation therapy
Lung surgery and radiation therapy are treatment options
for stage I and II, and some stage III and IV tumors. To
assess if you can have these treatments, your doctors
will need to know how well your lungs work. There are
three pulmonary function tests. A common side effect of
pulmonary function tests is shortness of breath.
involves blowing into a tube to measure
how much air and how fast you breathe.
gas diffusion test
involves breathing in a
harmless gas and measuring how much you breathe
out. It tells how much oxygen travels from your lungs
into your blood.
involves sitting in a small
room and breathing into a tube. This test measures
how much air your lungs can hold and how much air
is left in your lungs after you exhale.
5.2 Imaging tests
I, II, and III
IB, II, III, and some IV Brain MRI (
Some IIB and IIIA tumors MRI of spine and thoracic
PET/CT was described in Parts 2.1 and 2.2. It is
recommended for stages I, II, and III, if not done for
clinical staging. Stage IV is often found with a CT scan
and often the cancer has spread to more than one site.
In these cases, a PET scan is not needed. For earlier
stages, PET/CT may show cancer in the lymph nodes
within the chest and in other tissues. PET/CT findings of
distant metastases need to be confirmed with a biopsy or
another imaging test.
MRI may find small tumors in the brain that aren’t causing
symptoms. It is recommended for stages IB, II, and III. If
you have stage IV cancer, you may receive a brain MRI
only if you have symptoms suggesting the cancer has
spread to the brain. Such symptoms include unusual
headaches or weakness in a specific part of the body.
MRI uses radio waves and powerful magnets to take
pictures inside the body. A contrast dye may be used to
make the pictures clearer. An MRI may cause your body
to feel a bit warm.