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The Use of PET and PET/CT Scanning in Lung Cancer

United Kingdom

The first 20% of the full text of this article appears below.

Recently the use of positron-emission tomography (PET) or PET/computed tomography (PET/CT) has become invaluable in the investigation and staging of lung cancers. Currently in the United Kingdom, there are guidelines from both the National Institute for Health and Clinical Excellence and the Scottish Intercollegiate Guidelines Network regarding the use of PET scanning in lung cancer.^1,2 The key points of both guidelines are:

1. Surgical candidates on CT should have a PET scan with 18-fluorodeoxyglucose (FDG) to look for involved intrathoracic nodes and distant metastases.
   
2. Patients who are otherwise surgical candidates and have limited N2/3 disease of uncertain pathological significance should also have an FDG-PET scan.
   
3. Histological/cytological investigation should be performed to confirm N2/3 disease when FDG-PET is positive.
   
4. Histological/cytological confirmation is not required when there is definite distant metastatic disease or a high probability that the N2/N3 disease is metastatic.
   
5. Biopsy is not required when an FDG-PET scan for N2/N3 disease is negative, even with enlarged nodes on CT.
   

The practice in our unit varies somewhat from these guidelines, thus we looked at the evidence behind some of these guidelines and developed a protocol for the use of PET and PET/CT based on the current literature.

The first point we looked at was the use of in the evaluation of solitary pulmonary nodules (SPNs), as we felt that PET may be unnecessary for peripheral SPNs. Solitary pulmonary nodules are a common problem . . . [Full Text of this Article]