Positron emission tomography (PET) is increasingly used in the evaluation of non-small cell lung cancer. However, PET is imprecise in defining abnormal anatomy and computed tomography (CT) is superior. Scanners have been developed that incorporate PET and CT within the same machine and integrate the images produced. This study compares the diagnostic accuracy of this method with conventional techniques.

Conventional staging was performed on 50 patients using bronchoscopy and contrast enhanced CT scans; all had PET and integrated PET-CT scans. Forty patients underwent surgery; tumour stage was confirmed histologically in all patients and the nodal stage in 37. Two independent review bodies prospectively analysed the images. The results showed that, for tumour staging, integrated PET-CT scans were more accurate than CT alone (p=0.001), PET (p<0.001), and visual correlation of CT and PET scans (p=0.013; a value of 0.017 was deemed significant following Bonferroni’s correction for multiple comparisons). For nodal staging, integrated PET-CT scans were better than PET scans (p=0.013); there was no significant difference compared with CT or visual correlation of scans.

This is a promising study that indicates that integrated PET-CT may be the most appropriate imaging for assessment of non-small cell lung cancer. Larger trials are required to confirm efficacy and assess cost effectiveness.