The technology available today for evaluating lung problems has advanced considerably since I began my journey as a pulmonary physician. Nowhere is this more apparent than in our ability to image the chest and specifically the lungs to give us better clues as to what is going on.
Years ago, the only imaging available was the standard chest x-ray but when problems were found, diagnosis often entailed invasive procedures such as lung biopsy which require a major operation on the chest. Often the problems were found to be benign, and the patient had been subjected to a surgical procedure that carried significant risk.
Fortunately, science and technology advanced and computed axial tomography scanning (CAT scanning) was developed giving us a greater ability to define certain problems particularly lung nodules when screening for lung cancer. Stil there were limitations, but the biopsy techniques had improved and were less invasive, but it still required a judgement call and procedure.
Making that judgement call easier and more accurate has come about with the development of positron emission tomography scanning (PET scanning).
Patients can be given a specific type of sugar molecule which is taken up by a lung nodule that is cancerous much more than one that is not. This makes the decision to proceed with biopsy or a more extensive procedure somewhat easier particularly for patients with significant lung disease which puts them at risk for procedural complications.
No decision is perfect, but our tools have improved.
