title: [Positron emission tomography/computed tomography for lung cancer staging].
abstract: BACKGROUND
  PET/CT (Positron Emission Tomography/Computed Tomography) is widely used in nodal and metastatic staging of lung cancer patients.
  
  
  OBJECTIVE
  To analyze PET/CT detection of metastatic disease in patients with lung cancer.
  
  
  METHODS
  We reviewed retrospectively F18Fluorodeoxyglucose PET/CT scans performed between December 2008 and December 2013. We selected 143 patients aged 30 to 92 years (63% males) with confirmed lung cancer referred for staging, with no previous treatment. We reviewed whole body PET/CT and brain magnetic resonance images. SUVmax (Standardized Uptake Value maximum) of primary pulmonary lesion, hilar/mediastinal nodes, and distant metastases were calculated.
  
  
  RESULTS
  Histological types encountered were adenocarcinoma in 55%, squamous-cell in 15%, small-cell in 8%, large-cell in 6% and adeno-squamous in 2%. In 22 cases (15%) histology was not available. Nodal involvement was observed in 60% of patients (44% hilar and 48% mediastinal). Skip metastases (mediastinal involvement without hilum involvement) were encountered in 17% of cases, and were significantly more common among high uptake lung tumors (p < 0.01). Best SUVmax cut-off for node involvement was 4.4 for hilum and 4.0 for mediastinum (sensibility: 86.4%, specificity: 99.8%). Sixty six patients (46.2%) showed distant metastases on PET/CT. The most common metastases were osseous in 22%, adrenal in 16%, hepatic in14%, pulmonary in 14% and cerebral in 12%. PET/CT detected a second unexpected synchronic cancer in eight patients (6%).
  
  
  CONCLUSIONS
  PET/CT is accurate for nodal staging using an uptake index as SUVmax. Distant metastases are common, especially in bone, adrenal glands and liver.
authors: David
authors: D
authors: Ladrón de Guevara H
authors: Francisca
authors: F
authors: Furnaro L
authors: Sebastián
authors: S
authors: Yévenes A
authors: José Miguel
authors: JM
authors: Clavero R
authors: David
authors: D
authors: Lazo P
authors: Patricio
authors: P
authors: Rodríguez D
authors: Antonio
authors: A
authors: Piottante B
authors: Raúl
authors: R
authors: Pefaur D
authors: Claudio
authors: C
authors: Pardo B
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018196:Carcinoma, Adenosquamous / Q000000981:diagnostic imaging; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18