Recommendations
➤ Patients should undergo surveillance imaging for recurrence every 6
months for 2 years. (Moderate Recommendation; IC-L)
➤ Patients should undergo surveillance imaging for detection of new
primary lung cancers annually after the first 2 years. (Moderate
Recommendation; EB-I)
➤ Clinicians should use a diagnostic chest CT that includes the adrenals,
with contrast (preferred) or without contrast when conducting surveillance
for recurrence during the first two years post-treatment. (Moderate
Recommendation; IC-L)
Qualifying statement. There is no evidence of added benefit for a CT of the abdomen and
pelvis over a chest CT through the adrenals as a surveillance imaging modality for recurrence.
➤ Clinicians should use a low dose screening chest CT when conducting
surveillance for new lung primaries after the first two years post-
treatment. (Moderate Recommendation; IC-L)
➤ Clinicians should NOT use FDG-PET/CT as a surveillance tool. (Moderate
Recommendation; IC-L)
➤ Surveillance imaging may be omitted in patients who are clinically
unsuitable for or unwilling to accept further treatment. Age should not
preclude surveillance imaging. Consideration of overall health status,
chronic medical conditions and patient preferences is recommended.
(Weak Recommendation; IC-L).
➤ Clinicians should NOT use circulating biomarkers as a surveillance
strategy for detection of recurrence in patients who have undergone
curative intent treatment for stage I-III NSCLC or SCLC. (Moderate
Recommendation; IC-I)
➤ For stage I-III NSCLC patients, clinicians should NOT use brain MRI
for routine surveillance for recurrence in patients who have undergone
curative intent treatment. (Moderate Recommendation; IC-L)
➤ In patients who have undergone curative intent treatment for stage I-III
SCLC and did not receive prophylactic cranial irradiation (PCI), clinicians
should offer brain MRI every 3-months for the first year and every 6
months for the second year for surveillance. The same schedule may be
offered for patients who did receive PCI. (Weak Recommendation; IC-L)
Qualifying statement. Brain MRI should not be routinely offered to asymptomatic patients
after 2 years of disease-free survival.
