Diagnostic applications of nuclear medicine: Lung and mediastinal tumors

While CT and MRI provide high-resolution anatomic assessment of lung and mediastinal malignancies, [¹⁸F]FDG imaging is superior in differentiating benign from malignant lymphadenopathy and in the detection of distant metastases. Pre-therapy assessment with [¹⁸F]FDG can provide important prognostic information. In addition [¹⁸F]FDG PET/CT can eliminate about half of futile thoracotomies and is therefore recommended for staging of lung and mediastinal tumors. [¹⁸F]FDG imaging is also indicated in the diagnosis of recurrent disease and in monitoring treatment. [¹⁸F] FDG PET/CT has been introduced for radiation planning, enabling refining treatment volumes to allow increased dose in target volume and reduced toxicity to nontarget tissues. Although [¹⁸F]FDG is the most widely used tracer in oncology, other PET tracers are evaluated with specific clinical and research goals and may have a future role in the management of lung malignancies.