Medicina Nuclear e Radioterapia

A Practical Guide to Interpreting FDG PET and CT Nodal Findings in Lung Cancer

Abstract

Fatemeh Behnia, Antoine Leblond and Hubert Vesselle

FDG PET/CT has been used to help characterize indeterminate pulmonary nodules, and to stage Non-Small Cell Lung Cancer (NSCLC) since January of 1998. The ever-expanding utilization of this modality in oncologic imaging cancer patients presented unique challenges for imagers who may not have received specialized training in the interpretation of PET/CT images. Interpretation of FDG PET/CT is particularly challenging in the thorax where inflammatory processes are common and often coexist with malignancy, rendering accurate tumor staging difficult. This article presents a systematic approach to FDG PET/CT interpretation in lung cancer staging, addressing common confounding situations often encountered. Although this illustrative discussion focuses on lung cancer staging, most of these tips could be applied to other types of cancer as well.