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BACKGROUND PET/CT (Positron Emission Tomography/Computed Tomography) is widely used in nodal and metastatic staging of lung cancer patients. OBJECTIVE To analyze PET/CT detection of metastatic disease in patients with lung cancer. METHODS We reviewed retrospectively F18Fluorodeoxyglucose PET/CT scans performed between December 2008 and December 2013. We selected 143 patients aged 30 to 92 years (63% males) with confirmed lung cancer referred for staging, with no previous treatment. We reviewed whole body PET/CT and brain magnetic resonance images. SUVmax (Standardized Uptake Value maximum) of primary pulmonary lesion, hilar/mediastinal nodes, and distant metastases were calculated. RESULTS Histological types encountered were adenocarcinoma in 55%, squamous-cell in 15%, small-cell in 8%, large-cell in 6% and adeno-squamous in 2%. In 22 cases (15%) histology was not available. Nodal involvement was observed in 60% of patients (44% hilar and 48% mediastinal). Skip metastases (mediastinal involvement without hilum involvement) were encountered in 17% of cases, and were significantly more common among high uptake lung tumors (p < 0.01). Best SUVmax cut-off for node involvement was 4.4 for hilum and 4.0 for mediastinum (sensibility: 86.4%, specificity: 99.8%). Sixty six patients (46.2%) showed distant metastases on PET/CT. The most common metastases were osseous in 22%, adrenal in 16%, hepatic in14%, pulmonary in 14% and cerebral in 12%. PET/CT detected a second unexpected synchronic cancer in eight patients (6%). CONCLUSIONS PET/CT is accurate for nodal staging using an uptake index as SUVmax. Distant metastases are common, especially in bone, adrenal glands and liver.
David Ladrón de Guevara H, and
Francisca Furnaro L, and
Sebastián Yévenes A, and
José Miguel Clavero R, and
David Lazo P, and
Patricio Rodríguez D, and
Antonio Piottante B, and
Raúl Pefaur D, and
Claudio Pardo B
August 2009,
Annals of internal medicine,
David Ladrón de Guevara H, and
Francisca Furnaro L, and
Sebastián Yévenes A, and
José Miguel Clavero R, and
David Lazo P, and
Patricio Rodríguez D, and
Antonio Piottante B, and
Raúl Pefaur D, and
Claudio Pardo B
October 2013,
Seminars in roentgenology,
David Ladrón de Guevara H, and
Francisca Furnaro L, and
Sebastián Yévenes A, and
José Miguel Clavero R, and
David Lazo P, and
Patricio Rodríguez D, and
Antonio Piottante B, and
Raúl Pefaur D, and
Claudio Pardo B
February 2002,
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology,
David Ladrón de Guevara H, and
Francisca Furnaro L, and
Sebastián Yévenes A, and
José Miguel Clavero R, and
David Lazo P, and
Patricio Rodríguez D, and
Antonio Piottante B, and
Raúl Pefaur D, and
Claudio Pardo B
February 2014,
Annals of coloproctology,
David Ladrón de Guevara H, and
Francisca Furnaro L, and
Sebastián Yévenes A, and
José Miguel Clavero R, and
David Lazo P, and
Patricio Rodríguez D, and
Antonio Piottante B, and
Raúl Pefaur D, and
Claudio Pardo B
December 2009,
Asian cardiovascular & thoracic annals,
David Ladrón de Guevara H, and
Francisca Furnaro L, and
Sebastián Yévenes A, and
José Miguel Clavero R, and
David Lazo P, and
Patricio Rodríguez D, and
Antonio Piottante B, and
Raúl Pefaur D, and
Claudio Pardo B
July 2006,
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association,
David Ladrón de Guevara H, and
Francisca Furnaro L, and
Sebastián Yévenes A, and
José Miguel Clavero R, and
David Lazo P, and
Patricio Rodríguez D, and
Antonio Piottante B, and
Raúl Pefaur D, and
Claudio Pardo B
May 2011,
Journal of thoracic imaging,
David Ladrón de Guevara H, and
Francisca Furnaro L, and
Sebastián Yévenes A, and
José Miguel Clavero R, and
David Lazo P, and
Patricio Rodríguez D, and
Antonio Piottante B, and
Raúl Pefaur D, and
Claudio Pardo B
June 2003,
The New England journal of medicine,
David Ladrón de Guevara H, and
Francisca Furnaro L, and
Sebastián Yévenes A, and
José Miguel Clavero R, and
David Lazo P, and
Patricio Rodríguez D, and
Antonio Piottante B, and
Raúl Pefaur D, and
Claudio Pardo B
February 2014,
Scandinavian journal of gastroenterology,
David Ladrón de Guevara H, and
Francisca Furnaro L, and
Sebastián Yévenes A, and
José Miguel Clavero R, and
David Lazo P, and
Patricio Rodríguez D, and
Antonio Piottante B, and
Raúl Pefaur D, and
Claudio Pardo B
August 2011,
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer,
