Today doctors can get a clear picture of lung  cancer—literally—thanks to new scanning technology that has moved medicine far beyond the black-and-white world of X rays. You have probably heard of PET scans, CT scans, MRIs, and ultrasounds, but which one works best to identify cancer early?

In a recent research study, UAB specialists found that adding a PET scan to the standard lineup of tests improved their ability to determine the developmental stage of tumors by 20 percent. They also were able to better detect metastasis, or the spread of cancer.

“A PET scan is totally different from any other type of scan,” says Robert Cerfolio, M.D., UAB’s chief of thoracic surgery. “CAT scans, ultrasounds, and MRIs all look for masses or abnormal growths, or as I describe them to patients, ‘lumps and bumps.’ A PET scan, however, looks for tissue with abnormal activity; it’s a physiologic study.” In other words, the scan examines the activity of suspected cancer cells and compares it with the functions of normal cells.

Dr. Cerfolio adds that the newest PET technology integrates the scans that combine the search for irregularities in activity with CT imaging that reveals the “lumps and bumps,” giving physicians even more detailed knowledge about lung disease.

In the research study, UAB specialists also found that PET scans were useful in helping doctors quickly rule out cancer in some cases. “For example, a bone scan might say that a particular bone looks like it has cancer in it,” Dr. Cerfolio explains, “but a PET scan might show that the bone is benign—it’s inflamed or osteoarthritic rather than cancer. Then we would do a biopsy of the bone to find out if the PET scan is right.”

Clearly, PET and integrated PET-CT scans provide specialists with key advantages over past technologies. Because the new scans give physicians the ability to determine where lung cancer is in its development timeline—in addition to where it is in the body—they can make a more accurate diagnosis, says Dr. Cerfolio. As a result, patients can benefit from earlier treatment, as well as surgery and other treatments targeted to their particular stage of cancer. “Patients are more likely to get the correct therapy,” he says, “because the stage we diagnose is more likely to be correct.”