IMAGING OF PULMONARY MASS LESIONS WITH WHOLE-BODY POSITRON EMISSION TOMOGRAPHY AND FLUORODEOXYGLUCOSE

Background. The clinical staging and management of both primary and me tastatic lung lesions depends on accurate imaging techniques. Biochemi cal imaging with positron emission tomography, (PET), and the glucose analog 2-[F-18]-fluoro-2-deoxy-D-glucose, (FDG), complements anatomic imaging with conventional radiologic methods. Methods. A new ''whole-b ody'' PET FDG technique that produces two-dimensional, nontomographic and tomographic longitudinal images of the entire body has been develo ped at UCLA. Sixteen patients with known pulmonary nodules who had und ergone thoracic computed tomography (CT) were studied with whole-body PET FDG imaging at the UCLA Medical Center. Results. This PET FDG imag ing method identified metabolically active tumor foci in all eight pat ients with bronchogenic carcinomas, four patients with metastatic lesi ons to the thorax, and two patients with Hodgkin disease. All diagnose s were confirmed histologically. Additionally, the PET FDG technique d etected extrathoracic metastases in 4 of 16 patients. Thoracic CT was not diagnostic of neoplasm in two of the eight patients with bronchoge nic carcinomas. In one patient with an ACTH-producing bronchial carcin oid, the lesion ultimately was detected on high-resolution CT but was not metabolically active on PET FDG imaging. Conclusions. This is the first report of whole-body PET FDG imaging in patients with thoracic l esions. PET FDG imaging accurately detected metabolically active tumor (both intrathoracic and extrathoracic) in patients with bronchogenic carcinoma, pulmonary metastatic disease, and Hodgkin lymphoma. Because lung cancer is characteristically a multisystem disease, this whole-b ody PET FDG technique has significant implications for treatment plann ing.