Staging of Lung Cancer with Integrated PET–CT

To the Editor: Lardinois et al. (June 19 issue) 1 state that tumor and nodal staging is more accurate with integrated positron-emission tomography and computed tomography (PET–CT) than with CT or PET alone. In their study, PET alone was visually correlated with CT, which is the standard of practice for reading PET scans. However, Lardinois et al. used non–diagnostic-quality, non–contrast-enhanced CT, which is not the type generally used for correlation at most PET centers. It is not surprising that PET–CT outperformed CT alone in tumor staging, since the tumor stage was determined with the use of non–diagnostic-quality CT. Newer-generation PET scanners . . .