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Seeking a Home for a PET, Part 1^*

Defining the Appropriate Place for Positron Emission Tomography Imaging in the Diagnosis of Pulmonary Nodules or Masses

Frank C. Detterbeck, MD, FCCP; Steven Falen, MD, PhD; M. Patricia Rivera, MD, FCCP; Jan S. Halle, MD and Mark A. Socinski, MD, FCCP

^* From the Division of Cardiothoracic Surgery, Department of Surgery (Dr. Detterbeck); Department of Radiology (Dr. Falen); Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (Dr. Rivera); Department of Radiation Oncology (Dr. Halle); and Division of Medical Oncology, Department of Internal Medicine (Dr. Socinski), University of North Carolina at Chapel Hill, Chapel Hill, NC. Members of the Multidisciplinary Thoracic Oncology Program, University of North Carolina at Chapel Hill.

Correspondence to: Frank C. Detterbeck, MD, FCCP, Division of Cardiothoracic Surgery, Medical School Wing C, Room 354 CB# 7065, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7065; e-mail: fdetter{at}med.unc.edu

There is a growing experience with positron emission tomography (PET) in patients with pulmonary nodules or masses. As PET imaging becomes more widely available, it is important to thoughtfully define when application of this technology is warranted. Review of the literature to date suggests that PET imaging for diagnosis of pulmonary lesions is most useful in patients who have a low or intermediate risk of lung cancer as determined by an evaluation of symptoms, risk factors, and radiographic appearance. There is little role for PET in diagnosis in patients with a very low or a high risk of lung cancer, and there is little role in patients with lesions < 1 cm in diameter, or lesions suspected to be an infection, a bronchioloalveolar carcinoma, or a typical carcinoid tumor.

Key Words: diagnosis • lung cancer • positron emission tomography • solitary pulmonary nodule

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