Radiographics 1998 Jan-Feb;18(1):5-20
Thoracic FDG PET: state of the art.
Erasmus JJ, McAdams HP, Patz EF Jr, Goodman PC, Coleman RE.
The D-glucose analogue 2-(fluorine-18) fluoro-2-deoxy-D-glucose (FDG) is the
most commonly used radionuclide in positron emission tomography (PET) of the
thorax. Increased glucose metabolism by malignant cells allows physiologic
differentiation between benign and malignant abnormalities. FDG PET is
consequently useful in characterizing indeterminate pulmonary nodules and in
staging and assessing the response to treatment of lung cancer. FDG PET is
accurate in classification of indeterminate pulmonary nodules as benign. Nodules
with low FDG uptake are followed up radiographically; nodules with increased FDG
uptake should be evaluated with biopsy or resected. In the staging of lung
cancer, FDG PET is useful in evaluating local disease and pleural and chest wall
involvement. The accuracy of FDG PET in demonstrating intrathoracic metastatic
nodal disease is greater than that of computed tomography or magnetic resonance
imaging. Whole-body PET is useful in detection of extrathoracic metastases.
Conventional imaging often does not allow differentiation of tumor from
posttreatment scarring. Increased FDG uptake at the sites of residual
radiographic abnormalities is indicative of persistent or recurrent tumor.
