Lung tumors are typically identified by an x-ray, computerized tomography (CT), Magnetic Resonance Imaging (MRI) or Positron Emission Tomography (PET). Once a tumor is found, further testing is needed to determine if it is cancerous and if it has spread.

• Positron Emission Tomography (PET) – PET is one of the most advanced and powerful diagnostic imaging techniques available since it can effectively pinpoint the source of many of the most common cancers and help distinguish between benign and malignant tumors, streamlining testing and decreasing the need for invasive biopsies. Because PET scans represent cell function, lung cancer can be seen in its earliest stages.
• Video Assisted Thoracic Surgery (VATS) – Usually done under general anesthesia, VATS enables doctors to view the inside of the chest cavity after making only very small incisions. It allows surgeons to remove masses close to the outside edges of the lung and to test them for cancer using a much smaller surgery than doctors needed to use in the past. Sometimes a smaller biopsy will be done by a procedure called bronchoscopy.
• Bronchoscopy – In this procedure a thin tube with a camera is inserted through the mouth or nose and into the lungs to view the lungs and collect samples which are sent to the lab for analysis. A bronchoscopy is uncomfortable and performed under local anesthetic.
• Needle Biopsy – A needle biopsy is used for tumors that are on the edge of the lungs and cannot be seen in a bronchoscopy. During this procedure, a needle is inserted through the chest wall and guided to the tumor by x-ray or CT. A sample of tissue is removed and sent to the lab for analysis. A variation of a needle biopsy is a thoracentisis in which a sample of fluid surrounding the lung is obtained and examined for the presence of cancer cells.
• Thoracotomy – When the tumor cannot be reached via bronchoscopy, the only way to obtain a sample is by surgery. During surgery, as much of the tumor as possible is removed and sent to the lab for analysis. A thoracotomy is a major surgical procedure that requires several days in the hospital and takes weeks or months to recover.
• Mediastinoscopy – This surgery is used to determine if cancer has spread to the nymph nodes. It is also useful for examining the outside surface of the large tubes of the airways (such as the trachea) or for evaluating tumors or masses in the middle chest. A small incision is made under local anesthetic and an instrument is inserted behind the breastbone to remove a sample from the lymph nodes or masses located between the lungs.
• Other Tests – A CT, MRI or bone scan may be used to determine if lung cancer has spread to other parts of the body.

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