Background. Purpose of the work was to investigate the diagnostic value of chest radiography and CT in assessing lung cancer local extension in the chest, in consideration of consistent patterns of non-small cell lung cancer spread in the chest.

Material and methods. 335 patients were enrolled in our study matching the inclusion criteria. The purpose was to detect how accurate and specific radiologic signs were detecting the lesions and assessing the resectability of tumour. Radiological signs of cancer resectability were analysed as well considering the NSCLC histological type, growth type and lobe localisation.

Results. Adding evaluation criteria (tumour and mediastinum contact >3 cm, tumour contact with aorta circumference >90°) and morphology as one of invasion criteria, sensitivity rises from 50% up to 85%. Combining pleural thickening sign with pleural fluid sign and adenocarcinoma morphology as one of pleural malignancy predicting signs, the sensitivity reaches 100%. The lowest sensitivity and accuracy while evaluating mediastinal invasion was determined in the case of left upper lobe tumours. The diagnostic value of CT determining mediastinal invasion was better in peripheral tumours than in the central ones: sensitivity 80%, specificity 85%, accuracy 83% in peripheral tumours and 72%, 80% and 74% in the central ones, respectively.

Conclusions. Staging lung cancer by CT and considering lung cancer histology, growing type and localisation cancer extension may be helpful while assessing local lung cancer extension more accurately and selecting patients for further investigation.

Keywords: non-small cell lung cancer, local extension, radiological diagnostics