Advanced image-guided diagnosis and staging in patients with early-stage lung cancer

This thesis explores how diagnostic and staging practices in early-stage lung cancer can be improved through advanced imaging techniques. The first part focuses on the feasibility of a sentinel lymph node procedure, similar to those used in other cancers. While intraoperative application using indocyanine green proved successful, the procedure performed during diagnostic navigation bronchoscopy was technically feasible but insufficiently reliable for identifying lymph nodes on imaging.

The second part evaluates current diagnostic strategies. Routine use of endobronchial ultrasound in patients with small peripheral nodules was found to be valuable only in patients with imaging-based suspicion of lymph node metastasis. Furthermore, long-term follow-up of patients revealed that the risk of developing a second primary lung tumor is higher than previously assumed.

This thesis contributes to improved diagnostic decision-making and personalized care for people with early-stage lung cancer, offering new insights for earlier detection of recurrent or new disease.