Role of positron emission tomography computed tomography in carcinoma lung evaluation

Lung cancer has graduated from merely a reportable disease of 1912 to being the most common cause of cancer death in developed countries in recent years. The annual number of lung cancer deaths is greater than the combined cancer deaths from breast, colon and prostate. Its association with tobacco has been proved and is related to the type, amount of tobacco used, the age at initiation and duration of use. Significant advances have been made in the diagnosis and management of lung cancer over the past decade. The primary treatment of lung cancer is surgery and the best chance for a complete cure comes from the total resection of localized disease. Once nodal or distant metastases have developed, primary surgical intervention is ruled out and patient is considered for adjuvant chemotherapy with or without radiation therapy. Accurate staging and delineation of disease extent is therefore critical in the treatment planning of lung carcinoma patients. (18F) fluoro deoxy glucose (FDG) positron emission tomography (PET) has been proven to be a valuable noninvasive imaging modality in the evaluation of patients with known or suspected lung cancer and its integration with computed tomography (CT) has changed the face of PET imaging in many ways. This article will review the current role of FDG PET CT in the evaluation of pulmonary nodules, diagnosis, staging and restaging of non-small-cell lung carcinoma (NSCLC), role of PET in small cell lung Carcinoma (Ca), pleural disease and will also discuss its potential future applications.