Staging of mediastinal non-small cell lung cancer with FDG PET, CT, and fusion images: preliminary prospective evaluation.

PURPOSE: To evaluate use of positron emission tomography (PET) with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) in detection of mediastinal lymph node metastases from non-small cell lung cancer.

MATERIALS AND

METHODS

A prospective trial to compare FDG PET and computed tomography (CT) of the thorax was performed in 23 patients with newly diagnosed or suspected non-small cell lung cancer. Blinded interpretations of CT alone, PET alone, CT and PET together, and fusion images were performed, and the results were compared with pathologic results.

RESULTS

Nineteen of 23 patients had non-small cell lung cancer. Prevalence of mediastinal involvement was 41%. In staging disease in the mediastinum, CT alone was 64% sensitive, 44% specific, and 52% accurate, whereas PET alone and fusion images were 82% sensitive, 81% specific, and 81% accurate (P < .05).

CONCLUSIONS

FDG PET was more accurate than CT in staging disease in the mediastinum in patients with lung cancer and appears to be the preferred imaging method in this clinical setting.