NSCLC brain metastasis staging — SCE Respiratory MCQ

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ModerateLung CancerNSCLC brain metastasis stagingSCE Respiratory

A 68-year-old man has potentially resectable stage IIa NSCLC on PET-CT. He has new headaches but no focal neurological deficit. What is the most appropriate investigation?

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Correct answer: E — MRI brain

Neurological symptoms in NSCLC warrant brain imaging, and MRI brain is preferred to detect metastases that would change radical treatment planning. Peak flow, pleural pH and oximetry do not stage neurological symptoms. PET-CT can miss small brain metastases because of high background cerebral uptake.

Reference: NICE NG122 Lung Cancer