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01.03.2012 | Chest | Ausgabe 3/2012

European Radiology 3/2012

Integrated imaging of non-small cell lung cancer recurrence: CT and PET-CT findings, possible pitfalls and risk of recurrence criteria

European Radiology > Ausgabe 3/2012
Andrea Caulo, Saeed Mirsadraee, Fabio Maggi, Lucia Leccisotti, Edwin J. R. van Beek, Lorenzo Bonomo



To review the role of imaging in the diagnosis of recurrent disease in previously treated non-small cell lung cancer (NSCLC) and discuss the imaging pitfalls.


A comprehensive review of published literature on CT and PET imaging of NSCLC recurrence was performed. Diagnostic and prognostic values are discussed. Representative imaging examples are illustrated.


Up to 30% of NSCLC recurrences present as loco-regional, involving treated hemithorax and ipsilateral lymph nodes, while 70% present as metachronous distant metastases. CT and PET-CT play an important role in the early detection of recurrence; indications for imaging vary depending on pathological features.


Imaging plays a central role in the identification of recurrence and may predict prognosis.

Key Points

  • Lung cancer recurs after surgery in 30% to 75% of patients.
  • CT and PET-CT are crucial in identification of loco-regional recurrence.
  • Knowledge of potential pitfalls is essential, especially for parenchymal or nodal recurrence.
  • CT can diagnose metastases but further examinations (PET-CT, MRI) are often needed.
  • Morphological and functional imaging criteria may help in predicting recurrence.

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