Can imaging help improve the survival of cancer patients?

Survival, quality-adjusted survival and mortality are important and related measures of outcome in cancer care. The impact of imaging on these outcomes can be ascertained from observational and modelling studies, frequently performed to evaluate cost-effectiveness. Examples where incorporation of imaging into cancer care can be shown to improve survival include breast cancer screening, characterization of solitary pulmonary nodules, staging of non-small cell lung cancer, treatment response assessment in Hodgkin lymphoma, postoperative surveillance of colorectal cancer and selective internal radiation therapy of colorectal liver metastases. Modelling suggests the greatest opportunities for improvements in survival through imaging detection of cancer may lie in the investigation of mildly symptomatic patients. For applications where the improvements in survival are more modest, use of imaging frequently has additional demonstrable benefits including reductions in health care expenditure.