Mohsen Beheshti - M.D, Associate Professor of Nuclear Medicine Paracelsus Medical University , Salzburg, Austria

A wide spectrum of advantages has been brought about by the development of positronemission tomography-computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) inmanagement of cancer patients, particularly lung malignancies.The prevalence of lung cancer in patients with solitary pulmonary nodules (SPN) varieswidely from 2-13% in screening studies to 46-82% in FDG PET/CT studies. The combination ofPET and CT in the hybrid imaging has showed an excellent performance in classifying SPN asbenign or malignant, where the sensitivity of CT and the specificity of PET, result in an overallsignificantly improved accuracy.FDG PET/CT has emerged as the most accurate non-invasive method for the evaluation ofmediastinal lymph node in the preoperative staging of non-small-cell lung cancer (NSCLC) with asensitivity, specificity and accuracy of 96%, 93% and 94%, respectively. In addition, the use ofFDG PET/CT in preoperative staging resulted in a different stage from that determined by standardmethods in about 50% of patients, with the stage lowered in 20% and raised in 41% of patients.Furthermore, FDG PET/CT possesses a significant value in the predicting of prognosis,assessment of response to therapy, and distinguishing recurrence, taking advantage of evaluation ofmetabolic activity of lesions rather than merely appearance.In conclusion, the incremental use of FDG PET/CT in assessment of lung cancer leads to anoverall reduction in treatment costs because significant numbers of patients will receive lessexpensive palliative therapies rather than more expensive radical treatments.