Lung Cancer Staging - Tumor (T)

Detailed review of the T category for TNM lung cancer staging (8th edition)
Textbooks I like for chest radiology-
Med students and all residents: Felson’s Principles of Chest Roentgenology
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Radiology residents: Thoracic Imaging: Pulmonary and Cardiovascular Radiology
amzn.to/2YqzLLh
Thoracic radiology fellows: Muller’s Imaging of the Chest: Expert Radiology Series
amzn.to/3ouJ7QY

[@sagarwagle1]

I am a fourth year radiology resident, and I have watched your videos throughout my residency and learned a lot from them. I love how your videos are not very long, and to the point. Looking forward to watching your future videos.

[@narahcavis]

This is an amazing practical lecture that is so concisely delivered. Thank you!

[@danceforever792]

Amazing video... Explained the staging with such clarity , no confusing details and great examples....this is the way to go...👍

[@alitali94]

You’re clearly a naturally skilled educator, thank you for the great video

[@ThoracicRadiology]

My pleasure!

[@Emily-ye1qy]

Yes I was waiting for you to do in depth staging videos! thank you!!

[@cameronno6039]

Thank you for what you do. This was detailed with examples and concise.

[@sandraogungbemi5890]

Wow! This is so clearly explained. Thank you

[@vickyvicky2757]

Thank you for this amazing clear on-point lecture!

[@syedzaman1148]

thanks sir. this is the first lecture that i ever seen, so fantastic and palatable

[@skeletopedia3122]

This is a fantastic overview. Very important topic for everyday practice and also Board Exams!

[@hishambajwa5082]

Thank you for this. It would be great if you did a series on post-treatment lung cancer imaging, pitfalls and clinical dilemmas.

[@rootedindietetics]

This is so helpful for my case study. Thank you for sharing your expertise!

[@henryatkinson2083]

Great educational content for FRCR, thanks!

[@shrutigohel560]

Hi!! Excellent educational video. I am a Medical Oncology resident from India and have benefitted a lot in my understanding of the subject through your video.

[@ThoracicRadiology]

Thank you! Best of luck on your training. ✌️

[@kaushikn2038]

Loads of love doc❤️❤️

[@zeinshabarek5026]

That was super helpful, thank you doc

[@md.anwarhossain4300]

Thnx a lot,soft voice tone with decent presentation.

[@emmagevorgyan1820]

Thank you for great lecture!

[@tomoyen8114]

Thank you, fantastic overview👍

[@santhoshkumar-tt4sb]

Excellent presentation.

[@mragab73]

Thanks for the great channel Please, may you elaborate on lung biopsy approaches for different lung zone in a separate tutorial?

[@Wingsurf]

Great video!

[@samiral-bedeary9113]

Amazing video well done

[@thethtar9102]

Waiting for upcoming videos..Thz u so much..Ur videos support alots

[@biplopbohara8200]

thank you

[@kelumprasanna7262]

thanks a lot

[@maisabusinni9415]

hallo thank you for the great presentation. how do you regard the mediastinal invasion without obvious involvement of mediastina structures. for example, if the tumor is invading the fat of the mediastinum would that be T4 or T3?

[@Mohsinkhan-cu2ki]

Thanks

[@shwetayadav9291]

Pls post more videos!

[@fazaltahir4216]

Superb presentation 🎉❤

[@ThoracicRadiology]

Thanks a lot

[@stevengrappy8664]

Thank you for this video of explanation in great detail. I have multiple nodules with one specific being speculated and growing in my right upper lung. It was explained that it was in a difficult area to get to though, through the use of the latest robotics, I underwent a lung biopsy this morning and awaiting the results. I like that I am able to learn and research information like this for my current situation and learn much more in-depth about it. Thank you.

[@ThoracicRadiology]

Good luck to you

[@stevengrappy8664]

@@ThoracicRadiology Thank you very much, As an update, After the biopsy result, PET scan, etc. I have Stage 4 Adenocarcinoma in both lungs, lymph nodes along the mediastinum, and something within cells regarding in the fluid surrounding the lungs and other organs. Again I would like to say thank you for the videos and the detailed explanations that are given as it gives people such as myself the opportunity to learn and understand giving a much clearer understanding in what we research to educate ourselves. I have always had an interest in the medical field so I find the information very interesting as well. Thank you for taking the time to help educate us, It is greatly appreciated.

[@balamb11]

good day i'd like to ask a question w/ regards to lungs. My mother has undergone thoracentesis 5 years ago because of fluid build up in her lungs. Is it possible that the scar from the procedure bleed because she have cough for 12 weeks already(2022) but 2 days ago when she spat it has blood. The amount of blood is probably less than a tsp and its color is bright red not dark. My father died last march so my mother is a bit stressed so her weight dropped because she has no appetite during those times. Recently she gained weight and looks way better than before. Her voice is still the same nothing has changed, never had a fever or chills in the last 12 weeks, she never felt tired and she even garden daily. A few days before she spat with blood, there was an episode where she felt her heart palpitated, we checked it out its over 100 but less than 120 this is when she walked upstairs. Also the day she spat with blood we were having dinner, she kinda choked a bit while eating dried squid so she assumed it could be the cause. So my questions are : 1. what's the possibility its from the scar from her lungs why she spat blood because of her cough 2. is it possible from acute bronchitis 3. what are the chances i hope its not its lung cancer ( shes not a smoker ) her age is 70 4. she had tuberculosis before and finished the 6-9months medication and she recovered 5. she had mastectomy in 2019 (right breast) as a precaution to breast cancer it was stage 0 6. she had xray 3 months ago and it was clear ( before she had a cough) thank you and good day

[@ruarilee5432]

What would be the T staging for a single tumor invading a separate lobe? Or a single tumor that invades a mediastinal node (eg 4R invasion from a right upper lobe tumor)?

[@marlenechicoine4005]

How many stages can a nodule progress in the year between scans, starting with a normal baseline?

[@rasha3565]

thank you, it is very nice and informative, what about lymphangitis carcinomatosis? how can we stage or categorize it?

[@ThoracicRadiology]

Good question, TNM doesn't give us a way to classify this, but I would suggest that if it is bilateral, then it would be considered M1a. When lymphangitic carcinomatosis is present, there are usually many lymph nodes that are enlarged also.

[@Chloe.zyxwvu]

How common are variances in the measurements of tumors in CT scans when looked at by different radiologists, and does it matter at all? Say, one radiologist measures a mass as 7.5 x 4.0cm but another will measure that same mass as 9.2 x 4.7 cm. Can measurements typically be this varied from radiologist to radiologist?

[@ThoracicRadiology]

Yes, it is possible to be that different. Esp if one radiologist is using the axial images and another is using a different projection (like sagittal or coronal)

[@zptrading]

Hi Dr Rishi Agrawal How would you stage a lung cancer patient which has a non regional lymph node involvement (eg. Ipsilateral, contralateral axillary lymph node) . N3? M1?

[@ThoracicRadiology]

not 100% sure, but I think most oncologists treat these as M1

[@mayuriphukan9559]

Hi ! I want to know about survival from metastatic lung cancer stage 4, that was metastated from the uterine cancer.

[@ThoracicRadiology]

hi, you should probably contact your doctor for specific prognosis. also, when you search for information on the internet, you should go by where the cancer first started. so if the cancer first started in the lung, then it is called lung cancer, even if it spread to the bone. if it started in the uterus and spread to the lung, it is called uterine cancer with metastasis to the lung, etc.

[@xray3044]

謝謝！

[@ThoracicRadiology]

Thank you Steve!

[@MrWilberchan]

Hi Dr, is pleural tagging means visceral invasion?

[@ThoracicRadiology]

No not necessarily. That has to be determined by path.

[@jugaljames9829]

How do you differentiate visceral vs parietal pleural invasion when tumor is abutting the coastal pleura?

[@ThoracicRadiology]

If the lesion is clearly going to the chest wall then you can say that it has invaded the parietal pleura. Short of that, then it requires a pathologist to determine whether there is visceral or parietal pleural invasion.

[@jugaljames9829]

@@ThoracicRadiology thank you very much. Amazing videos sir.

[@judylantz4929]

So you can have a T3 strictly by size, if surgically totally by thoracotomy and found no where else it still remains a T3?

[@ThoracicRadiology]

Yes sounds right to me

[@ayanshah5009]

Sir what T4N3M1 means ...plz tell....is this an advanced stage .... because it hadn't spread to somewhere else right now

[@ThoracicRadiology]

M1 means that it is advanced...the tumor has spread to distant organs.

[@hereforit2581]

Do you have an email to contact you? I have a couple questions I would love to ask.

[@irynarasscupkina6672]

👏👏👏👏👏

[@aminebachi947]

If its 2cm but there is invasion of main bronchus is it T2 now or what

[@ThoracicRadiology]

yeah main bronchus invasion is T2

[@aminebachi947]

@@ThoracicRadiology thank you

[@normariccobene6932]

Amazing how all these tests yet my if the tumor gets so big than opps your terminal opps get your affairs opps you have end stage small cell. Sorry that's how quickly it went with my,late mother