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.