State-of-the-art FDG-PET imaging of lung cancer

The d-glucose analog 2-(fluorine-18)-fluoro-2-deoxy-d-glucose (FDG) is the most commonly used radionuclide in positron emission tomography (PET) of lung cancer. FDG-PET is a molecular imaging technique that images the preferential accumulation of FDG in malignant tissues with increased metabolism. Although FDG-PET is sensitive in the detection of lung cancer, FDG is not tumor specific and may accumulate in a variety of nonmalignant conditions. Occasional false-negative results may also occur. Whole body FDG-PET is a useful noninvasive technique to stage known or suspected non-small-cell lung cancer. The results allow more efficient use of invasive methods for histopathological staging. The combined use of CT and PET in dual imaging increases the number of patients with correctly staged non-small-cell lung cancer. CT/PET is also useful in the assessment of recurrent or residual disease. Future imaging agents are being developed which may allow more selective accumulation of radiopharmaceutical in malignant tissues.