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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 images of a 60-year-old male patient diagnosed with non-small cell lung cancer and undergoing radiotherapy. Although a large mass in the right upper lobe was detected on chest CT imaging (A), the differentiation between the tumor and normal surrounding structures would not have been feasible without the aid of PET/CT (B).
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f04: PET/CT images of a 60-year-old male patient diagnosed with non-small cell lung cancer and undergoing radiotherapy. Although a large mass in the right upper lobe was detected on chest CT imaging (A), the differentiation between the tumor and normal surrounding structures would not have been feasible without the aid of PET/CT (B).

Mentions: The higher diagnostic accuracy provided by PET/CT has had a major impact on the treatment of lung cancer patients undergoing radiotherapy. That accuracy has improved radiotherapy for lung cancer mainly because it allows the limits of the tumor(s) to be defined with precision, thus preventing mistargeting and the unnecessary irradiation of adjacent structures (Figure 4). For instance, recent studies have demonstrated that the use of PET/CT in the planning of radiotherapy was consistently able to reduce radiation doses for esophageal and pulmonary lesions.(19,20) In addition, the higher sensitivity of FDG-PET (in comparison with CT) in detecting abnormal mediastinal lymph nodes has allowed PET/CT to be used in performing target volume delineation using anatomical biological contouring, with even better results.(3)


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 images of a 60-year-old male patient diagnosed with non-small cell lung cancer and undergoing radiotherapy. Although a large mass in the right upper lobe was detected on chest CT imaging (A), the differentiation between the tumor and normal surrounding structures would not have been feasible without the aid of PET/CT (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f04: PET/CT images of a 60-year-old male patient diagnosed with non-small cell lung cancer and undergoing radiotherapy. Although a large mass in the right upper lobe was detected on chest CT imaging (A), the differentiation between the tumor and normal surrounding structures would not have been feasible without the aid of PET/CT (B).
Mentions: The higher diagnostic accuracy provided by PET/CT has had a major impact on the treatment of lung cancer patients undergoing radiotherapy. That accuracy has improved radiotherapy for lung cancer mainly because it allows the limits of the tumor(s) to be defined with precision, thus preventing mistargeting and the unnecessary irradiation of adjacent structures (Figure 4). For instance, recent studies have demonstrated that the use of PET/CT in the planning of radiotherapy was consistently able to reduce radiation doses for esophageal and pulmonary lesions.(19,20) In addition, the higher sensitivity of FDG-PET (in comparison with CT) in detecting abnormal mediastinal lymph nodes has allowed PET/CT to be used in performing target volume delineation using anatomical biological contouring, with even better results.(3)

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