Background: The goal of preoperative staging of non-small-cell lung cancer (NSCLC) is to identify patients who will benefit from surgical resection. Various imaging and less invasive modalities are now available to improve therapy decision making.
Methods: The available staging methods are reviewed, including conventional methods, surgical staging, and less invasive means of pathologic staging.
Results: Computed tomography alone is not sufficiently accurate to stage the mediastinum, and further definitive testing is usually indicated. Positron emission tomography, along with mediastinal biopsy techniques using transbronchial needle aspiration or endoscopic ultrasound, has the potential to improve the accuracy of pretreatment staging.
Conclusions: Every effort should be made to accurately discriminate between benign and malignant mediastinal disease. With further research on the proper roles of these new imaging modalities, they will become more widely used and will improve the accuracy of pretreatment staging of NSCLC.