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PET/CT imaging in lung cancer: indications and findings.

Hochhegger B, Alves GR, Irion KL, Fritscher CC, Fritscher LG, Concatto NH, Marchiori E - J Bras Pneumol (2015 May-Jun)

Bottom Line: In addition, the accuracy of PET/CT has been shown to be greater than is that of conventional modalities in some scenarios, making PET/CT a valuable noninvasive method for the investigation of lung cancer.However, the interpretation of PET/CT findings presents numerous pitfalls and potential confounders.Therefore, it is imperative for pulmonologists and radiologists to familiarize themselves with the most relevant indications for and limitations of PET/CT, seeking to protect their patients from unnecessary radiation exposure and inappropriate treatment.

View Article: PubMed Central - PubMed

Affiliation: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

ABSTRACT
The use of PET/CT imaging in the work-up and management of patients with lung cancer has greatly increased in recent decades. The ability to combine functional and anatomical information has equipped PET/CT to look into various aspects of lung cancer, allowing more precise disease staging and providing useful data during the characterization of indeterminate pulmonary nodules. In addition, the accuracy of PET/CT has been shown to be greater than is that of conventional modalities in some scenarios, making PET/CT a valuable noninvasive method for the investigation of lung cancer. However, the interpretation of PET/CT findings presents numerous pitfalls and potential confounders. Therefore, it is imperative for pulmonologists and radiologists to familiarize themselves with the most relevant indications for and limitations of PET/CT, seeking to protect their patients from unnecessary radiation exposure and inappropriate treatment. This review article aimed to summarize the basic principles, indications, cancer staging considerations, and future applications related to the use of PET/CT in lung cancer.

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Thoracic PET/CT scans (left) and a PET scan (right), which were performed for the staging of a 57-year-old female patient diagnosed with non-small cell lung cancer. By combining anatomical details with functional data, PET/CT allows more reliable detection of mediastinal and ipsilateral metastatic disease.
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f01: Thoracic PET/CT scans (left) and a PET scan (right), which were performed for the staging of a 57-year-old female patient diagnosed with non-small cell lung cancer. By combining anatomical details with functional data, PET/CT allows more reliable detection of mediastinal and ipsilateral metastatic disease.

Mentions: Given its excellent anatomical resolution, CT remains an important modality for T stage assessment, although its ability to evaluate soft tissue invasion or to distinguish primary lesions from post-obstructive atelectasis is fairly limited. Comparatively, PET imaging provides pertinent data on the metabolic behavior of a lesion, although it is unable to detect microscopic tumor deposits and low-activity nodules (such as adenomas, carcinoid tumors and bronchioloalveolar carcinomas) or to detail important anatomical findings in NSCLC. Nevertheless, PET/CT significantly improves T staging, due to its precise CT correlation with the degree of FDG uptake (Figure 1). Previous studies have demonstrated that integrated PET/CT provides crucial information on mediastinal infiltration and chest wall invasion, as well as allowing the differentiation between tumor and post-obstructive atelectasis, which can present challenges when the T staging of NSCLC is performed with CT alone.(3,13)


PET/CT imaging in lung cancer: indications and findings.

Hochhegger B, Alves GR, Irion KL, Fritscher CC, Fritscher LG, Concatto NH, Marchiori E - J Bras Pneumol (2015 May-Jun)

Thoracic PET/CT scans (left) and a PET scan (right), which were performed for the staging of a 57-year-old female patient diagnosed with non-small cell lung cancer. By combining anatomical details with functional data, PET/CT allows more reliable detection of mediastinal and ipsilateral metastatic disease.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541763&req=5

f01: Thoracic PET/CT scans (left) and a PET scan (right), which were performed for the staging of a 57-year-old female patient diagnosed with non-small cell lung cancer. By combining anatomical details with functional data, PET/CT allows more reliable detection of mediastinal and ipsilateral metastatic disease.
Mentions: Given its excellent anatomical resolution, CT remains an important modality for T stage assessment, although its ability to evaluate soft tissue invasion or to distinguish primary lesions from post-obstructive atelectasis is fairly limited. Comparatively, PET imaging provides pertinent data on the metabolic behavior of a lesion, although it is unable to detect microscopic tumor deposits and low-activity nodules (such as adenomas, carcinoid tumors and bronchioloalveolar carcinomas) or to detail important anatomical findings in NSCLC. Nevertheless, PET/CT significantly improves T staging, due to its precise CT correlation with the degree of FDG uptake (Figure 1). Previous studies have demonstrated that integrated PET/CT provides crucial information on mediastinal infiltration and chest wall invasion, as well as allowing the differentiation between tumor and post-obstructive atelectasis, which can present challenges when the T staging of NSCLC is performed with CT alone.(3,13)

Bottom Line: In addition, the accuracy of PET/CT has been shown to be greater than is that of conventional modalities in some scenarios, making PET/CT a valuable noninvasive method for the investigation of lung cancer.However, the interpretation of PET/CT findings presents numerous pitfalls and potential confounders.Therefore, it is imperative for pulmonologists and radiologists to familiarize themselves with the most relevant indications for and limitations of PET/CT, seeking to protect their patients from unnecessary radiation exposure and inappropriate treatment.

View Article: PubMed Central - PubMed

Affiliation: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

ABSTRACT
The use of PET/CT imaging in the work-up and management of patients with lung cancer has greatly increased in recent decades. The ability to combine functional and anatomical information has equipped PET/CT to look into various aspects of lung cancer, allowing more precise disease staging and providing useful data during the characterization of indeterminate pulmonary nodules. In addition, the accuracy of PET/CT has been shown to be greater than is that of conventional modalities in some scenarios, making PET/CT a valuable noninvasive method for the investigation of lung cancer. However, the interpretation of PET/CT findings presents numerous pitfalls and potential confounders. Therefore, it is imperative for pulmonologists and radiologists to familiarize themselves with the most relevant indications for and limitations of PET/CT, seeking to protect their patients from unnecessary radiation exposure and inappropriate treatment. This review article aimed to summarize the basic principles, indications, cancer staging considerations, and future applications related to the use of PET/CT in lung cancer.

Show MeSH
Related in: MedlinePlus