Staging non-small cell lung cancer with whole-body PET

PURPOSE: To compare the accuracies of whole-body 2-[fluorine 18]fluoro-deox y-D-glucose (FDG) positron emission tomography (PET) and conventional imagi ng (thoracic computed tomography [CT], bone scintigraphy, and brain CT or m agnetic resonance [MR] imaging) in staging bronchogenic carcinoma. MATERIALS AND METHODS: Within: 20 months, 100 patients with newly diagnosed bronchogenic carcinoma underwent whole-body FDG PET and chest CT. Ninety o f these patients underwent radionuclide bone scintigraphy, and 70 patients underwent brain CT or MR imaging. For each patient, all examinations were c ompleted within 1 month. A radiologic stage was assigned by using PET and c onventional imaging independently and was compared with the pathologic stag e. The accuracy, sensitivity, specificity, and negative and positive predic tive values were calculated. RESULTS: PET staging was accurate in 83 (83%) patients; conventional imagin g staging was accurate in 65 (65%) patients (P < .005). Staging with medias tinal lymph-nodes was correct by using PET in 67 (85%) patients and by usin g CT in 46 (58%) patients (P < .001). Nine (9%) patients had metastases dem onstrated by using PET that were not found with conventional imaging, where as 10 (10%) patients suspected of having metastases because of conventional imaging findings were correctly shown with PET to not have metastases. CONCLUSION: Whole-body PET was more accurate than thoracic CT, bone scintig raphy, and brain CT or MR imaging in staging bronchogenic carcinoma.