Diagnosis involves a number of tests, including:
X-ray
X-rays are quick and painless. They can be used to produce images of the inside of the body to help detect a range of conditions. Lung tumors or masses can appear on a chest X-ray as white or grey shadows that are different from normal lung tissue. You will usually be asked to stand or sit by the X-ray machine and a radiographer will position you in the best place to take images of your lungs. The images can be taken in a few seconds and may be taken from a few different positions. X-rays are not effective for screening and more detailed scans are required.
Computerised tomography (CT) scan
High-resolution CT scans are quick and painless. The scanning machine is usually a large donut-shaped machine with a short tunnel in the centre. The images are produced as you lie on a flat bed that moves under the scanning machine, in and out of the short tunnel. A radiographer operates the machine from the next room to take the pictures that are required.
A biopsy
A biopsy involves taking samples from your lungs to further check any suspicious cells that were shown in the earlier tests. Biopsies can be carried out in a number of ways, most of which are done as an outpatient (you do not stay over):
- A bronchoscopy – this uses a flexible tube that has a video camera at the end (called a bronchoscope) to look inside your lungs. The tube is inserted through your nose or mouth. You will receive a sedative to relax you and a spray to numb your throat. Read more about bronchoscopy on the European Lung Foundation’s website.
- Endobronchial ultrasound (EBUS) – this is similar to a bronchoscopy. The bronchoscope is fitted with a small ultrasound probe to help guide the physician to the right area to take a sample. This area is usually the area between the two lungs where your glands sit (called mediastinum).
- CT-guided biopsy (where you go through the CT scanner and the X-ray images guide the physician to the right area).
- US (ultrasound) guided biopsy (where the physician uses an ultrasound device to identify the right area and inserts a needle in it to take a biopsy. Local anaesthetic is used to numb the area where the needle will be inserted)
- Surgery – where a surgeon obtains a biopsy generally in the least invasive way possible. This is using a thoracoscope, a traditional incision or a robot. The procedure is performed under general anaesthesia and a chest tube remains in place for a few hours or in some cases days to re-expand the lung. If the lung modules are tiny, it is also possible for the surgeon to remove them completely, meaning that this test could also be a form of treatment and not just diagnosis.