title: Combined contrast-enhanced computed tomography and 18-fluoro-2-deoxy-D-glucose-positron emission tomography in the diagnosis and staging of non-small cell lung cancer.
abstract: We present the current optimal uses and limitations of positron emission tomography/computed tomography (PET/CT) as it relates to the diagnosis and staging of non-small cell lung cancer (NSCLC). PET/CT demonstrates increased accuracy in the workup of solitary pulmonary nodules for malignancy compared with CT alone, and we discuss its benefits and limitations. We review pitfalls in measured standardized uptake values of lung lesions caused by respiratory artifacts, the lower sensitivity for detection of small lung nodules on non-breath-hold CT, and the benefits of obtaining an additional diagnostic CT for the maximum sensitivity of lung nodule detection. There are limitations of quantitatively comparing separate PET/CT examinations from different facilities with standardized uptake values. As for staging, we describe how PET/CT supplements clinical tumor-nodes-metastases (ie, TNM) staging, as well as mediastinoscopy, endobronchial ultrasound, and endoscopic ultrasound, which are the gold standard pathologic staging methods. We touch on the 7th edition TNM staging system based on the work by the International Association for the Study of Lung Cancer, an anatomically based staging method.
authors.affiliation: Department of Radiology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, USA. allen124@umn.edu
authors.forename: Tadashi L
authors.initials: TL
authors.lastname: Allen
authors.forename: Ayse Tuba Karagulle
authors.initials: AT
authors.lastname: Kendi
authors.forename: Mohi O
authors.initials: MO
authors.lastname: Mitiek
authors.forename: Michael A
authors.initials: MA
authors.lastname: Maddaus
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D003287:Contrast Media; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18