Comparative efficacy of positron emission tomography with FDG and computedtomographic scanning in preoperative staging of non-small cell lung cancer

Objective To determine the sensitivity, specificity, and accuracy of positr on emission tomography with 2-fluorine-18- fluorodeoxy-glucose (PET-FDG) in the preoperative staging (N and M staging) of patients with lung cancer. T he authors wanted to compare the efficacy of PET scanning with currently us ed computed tomography (CT) scanning. Materials and Methods Results of whole-body PET-FDG imaging and CT scans we re compared with histologic findings for the presence or absence of lymph n ode disease or metastatic sites. Sampling-of mediastinal lymph nodes was pe rformed using mediastinoscopy or thoracotomy. Results PET-FDG imaging was significantly more sensitive, specific, and acc urate for detecting N disease than CT. PET changed N staging in 35% and M s taging in 11% of patients. CT scans helped in accurate anatomic localizatio n of 6/57 PET lymph node abnormalities. Conclusion PET-FDG is a reliable method for preoperative staging of patient s with lung cancer and would help to optimize management of these patients. Accurate lymph node staging of lung cancer may be ideally performed by sim ultaneous review of PET and CT scans.