Imaging of Precision Therapy for Lung Cancer: Current State of the Art

Authors: Hyesun Park, Lynette M. Sholl, Hiroto Hatabu, Mark M. Awad, Mizuki Nishino


Advances in characterization of molecular and genomic abnormalities specific to lung cancer have made precision therapy the current standard of care for lung cancer treatment. This article will provide a cutting-edge review of imaging of lung cancer in the current era of precision medicine. The focus of the article includes (a) an update on the recent advances in precision therapy for non–small cell lung cancer and their implications on imaging; (b) molecular and genomic biomarkers and pitfalls of image interpretations for lung cancer precision therapy; and (c) review of the current approaches and future directions of precision imaging for lung cancer, emphasizing emerging observations in longitudinal tumor kinetics, radiomics, and molecular and functional imaging. The article is designed to help radiologists to remain up to date in the rapidly evolving world of lung cancer therapy and serve as key members of multidisciplinary teams caring for these patients.

© RSNA, 2019

Online supplemental material is available for this article.


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Summary
The knowledge of the recent advances of precision lung cancer therapy and their impact on image-based diagnosis and treatment monitoring is essential for radiologists to continue to be key members of multidisciplinary lung cancer care.

Essentials
The precision medicine approaches to lung cancer continue to rapidly advance in the clinical practice setting.

Familiarity with pre- and posttherapy imaging characteristics of lung cancer treated with precision therapy is essential for accurate interpretation of imaging studies.

Imaging pitfalls of precision lung cancer therapy, including immune-related tumor response and drug toxicities, should be recognized.