Superior vena cava (SVC) syndrome occurs in approximately 15,000 people in the United States each year. It most commonly occurs secondary to thoracic malignancies, mostly primary lung cancer and lymphoma. The cause is occlusion of the SVC or brachiocephalic veins. The following recommendations for initial imaging evaluation of acute or chronic SVC syndrome are presented. Contrast-enhanced chest CT scans, particularly CT angiography/venography, with or without simultaneous inclusion of the neck a…