What is the role of PET-CT in the staging of secondary lung cancer?

Updated: Feb 16, 2021
  • Author: Daniel S Schwartz, MD, MBA, FACS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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PET-CT has enhanced the ability to spatially identify structures that could more accurately evaluate the stage, as well as the individual T, N, and M status, in patients with NSCLC. [13, 21]

Only FDG-18 is currently used in PET-CT scans, but new radiopharmaceuticals and the prospects for developing other new radiotracers for imaging seem to be promising. [22]  As before, any new radiotracer must be carefully assessed to determine its accuracy at each nodal station and at each metastasis site.

In a retrospective study of 50 patients with lung lesions suspicious for cancer, integrated CT-PET correctly predicted T status in 86% of patients, N status in 80% of patients, M status in 98% of patients, and TNM status in 70% of patients. In comparison, correct prediction rates with CT alone were lower, reaching 68%, 66%, 88%, and 46%, respectively. With PET alone, the correct prediction rates were 46%, 70%, 96%, and 30%, respectively, and with visually correlated CT and PET scans, the correct prediction rates were 72%, 68%, 96%, and 54%, respectively.

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