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DOI: 10.1148/rg.282075709
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RadioGraphics 2008;28:551-560
© RSNA, 2008

EDUCATION EXHIBIT

Imaging of Non–Small Cell Lung Cancer of the Superior Sulcus

Part 1: Anatomy, Clinical Manifestations, and Management1

John F. Bruzzi, FFRRCSI, Ritsuko Komaki, MD, Garrett L. Walsh, MD, Mylene T. Truong, MD, Gregory W. Gladish, MD, Reginald F. Munden, MD, and Jeremy J. Erasmus, MD

1 From the Division of Diagnostic Imaging (J.F.B., M.T.T., G.W.G., R.F.M., J.J.E.), Department of Radiation Oncology (R.K.), and Department of Thoracic and Cardiovascular Surgery (G.L.W.), M. D. Anderson Cancer Center, Houston, Tex. Received March 9, 2007; revision requested May 25 and received June 26; accepted June 29. All authors have no financial relationships to disclose. Address correspondence to J.F.B., Department of Radiology, University College Hospital Galway, Galway, Ireland (e-mail: John.Bruzzi{at}hse.ie).

Non–small cell carcinomas of the superior pulmonary sulcus represent 3% of all lung cancers and are associated in most cases with a poor clinical outcome. Multimodality therapy with irradiation, chemotherapy, and surgery offers the best possibility for long-term survival and cure in most cases. For patients with pulmonary sulcus tumors that are not surgically resectable, chemoradiotherapy may help prolong survival and provide long-term pain relief. To accurately determine tumor resectability and to help optimize the planning and delivery of therapy, radiologists need a detailed knowledge of the clinical and imaging manifestations of disease in the individual patient and an awareness of the therapeutic options available. Accurate three-dimensional imaging and image interpretation are essential for mapping of the primary tumor before irradiation or surgical resection. Familiarity with the complex anatomy of the superior pulmonary sulcus is particularly crucial for determining the local-regional extension of a tumor and the most appropriate surgical approach.

© RSNA, 2008


Related Article

Imaging of Non–Small Cell Lung Cancer of the Superior Sulcus: Part 2: Initial Staging and Assessment of Resectability and Therapeutic Response
John F. Bruzzi, Ritsuko Komaki, Garrett L. Walsh, Mylene T. Truong, Gregory W. Gladish, Reginald F. Munden, and Jeremy J. Erasmus
RadioGraphics 2008 28: 561-572. [Abstract] [Full Text] [PDF]





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