Preoperative Staging of Lung Cancer with Combined PET–CT

Combined positron-emission tomography and computed tomography (PET–CT) plus conventional staging was compared with conventional staging alone for preoperative staging of non–small-cell lung cancer (NSCLC). The end point was the number of futile thoracotomies in each group (with futility defined as a result other than potentially curable NSCLC). Preoperative staging of NSCLC with PET–CT was found to reduce the total number of thoracotomies and the number of futile thoracotomies. Preoperative staging of non–small-cell lung cancer with PET–CT was found to reduce the total number of thoracotomies and the number of futile thoracotomies. Staging of non–small-cell lung cancer (NSCLC) was one of the first approved indications for the use of positron-emission tomography (PET). 1 , 2 Since 2001, combined PET and computed tomography (PET–CT) has rapidly replaced stand-alone PET. 3 , 4 The diagnostic capability of PET–CT in the preoperative staging of NSCLC is superior to that of CT alone and PET alone. 5 The advantage is based mainly on a more accurate assignment of tumor stage (T stage) and to a lesser extent on defining the lymph-node stage (N stage). 5 – 7 Whether the improved diagnostic accuracy improves management of the disease is unknown. Two randomized trials have . . .