What is the role of PET scans in the staging of non-small cell lung cancer (NSCLC)?

Updated: Aug 27, 2019
  • Author: Sat Sharma, MD, FRCPC; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

Positron emission tomography (PET) can be used to determine the metabolic activity rather than the morphologic features of the lesions. Bronchogenic carcinoma is associated with an increased rate of glucose metabolism. PET uses deoxyglucose linked to fluorine-18 (a positron emitter). The agent, 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG), competes with glucose for transport into the cells and, after phosphorylation, accumulates in tumor cells. Lung tumor cells have increased glucose metabolism; however, this is not specific for tumors and may occur in infectious or inflammatory processes.

FDG-PET scanning has been used to differentiate benign from malignant pulmonary nodules. PET scans may also be useful in detecting distant metastases when whole-body imaging is performed. Because of the false-positive rate, invasive staging procedures may still be required before potentially curative surgical management is denied. [22, 23, 24]


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