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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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Related in: MedlinePlus

PET/CT assessment allowing the diagnosis of bone metastases (A) and adrenal metastases (B) in a 79-year-old male patient with non-small cell lung cancer. Although such lesions were suggested by PET alone (C), their precise location and delineation could not be determined without the addition of CT. J Bras
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f03: PET/CT assessment allowing the diagnosis of bone metastases (A) and adrenal metastases (B) in a 79-year-old male patient with non-small cell lung cancer. Although such lesions were suggested by PET alone (C), their precise location and delineation could not be determined without the addition of CT. J Bras

Mentions: The conventional M staging protocol has long included CT scans of the chest and upper abdomen (liver and adrenal gland screening). When IIIA or IIIB disease occurs, bone scintigraphy and brain imaging (with either CT or MRI) are typically also performed in order to investigate lesions of the bone and central nervous system (CNS), respectively.(3) However, PET/CT imaging has recently shown great utility in the M staging of patients with NSCLC (Figure 3), particularly in those with clinical manifestations of the disease. In addition, PET/CT is able to provide more pertinent information during the preoperative assessment than is CT alone, with the exception of the assessment of brain metastases, for which the two modalities yield similar results and have similar limitations.(12)


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)

PET/CT assessment allowing the diagnosis of bone metastases (A) and adrenal metastases (B) in a 79-year-old male patient with non-small cell lung cancer. Although such lesions were suggested by PET alone (C), their precise location and delineation could not be determined without the addition of CT. J Bras
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f03: PET/CT assessment allowing the diagnosis of bone metastases (A) and adrenal metastases (B) in a 79-year-old male patient with non-small cell lung cancer. Although such lesions were suggested by PET alone (C), their precise location and delineation could not be determined without the addition of CT. J Bras
Mentions: The conventional M staging protocol has long included CT scans of the chest and upper abdomen (liver and adrenal gland screening). When IIIA or IIIB disease occurs, bone scintigraphy and brain imaging (with either CT or MRI) are typically also performed in order to investigate lesions of the bone and central nervous system (CNS), respectively.(3) However, PET/CT imaging has recently shown great utility in the M staging of patients with NSCLC (Figure 3), particularly in those with clinical manifestations of the disease. In addition, PET/CT is able to provide more pertinent information during the preoperative assessment than is CT alone, with the exception of the assessment of brain metastases, for which the two modalities yield similar results and have similar limitations.(12)

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