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Yield of Brain ¹⁸F-FDG PET in Evaluating Patients with Potentially Operable Non–Small Cell Lung Cancer

¹ Department of Surgery, Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, North Carolina; ² Department of Biostatistics, Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, North Carolina; ³ Thoracic Oncology Program, Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, North Carolina; ⁴ Division of Cardiothoracic Surgery, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina; ⁵ Vanderbilt University Medical Center, Nashville, Tennessee; ⁶ Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York; and ⁷ Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri

View larger version (49K): [in a new window]   FIGURE 1.  Selected brain 18F-FDG PET images of 56-y-old man (patient 1) with adenocarcinoma of right middle lobe demonstrate small focus of increased uptake (arrows) in left cerebellar tonsil. Subsequent MRI showed no evidence of metastasis. Patient underwent resection of lung cancer and was free of disease at 7-mo follow-up.

View larger version (49K): [in a new window]   FIGURE 2.  Selected brain 18F-FDG PET images of 73-y-old man (patient 2) with mixed adenocarcinoma/neuroendocrine tumor of right lower lobe demonstrate increased 18F-FDG uptake (arrows) in pituitary gland. Pituitary adenoma was considered less likely than metastasis because of intensity of this lesion. Subsequent MRI showed changes typical of pituitary adenoma but also demonstrated enhancing lesion suggestive of metastasis in right cerebellar peduncle/pons (which was not seen on PET images). Patient underwent resection of lung cancer and was free of disease at 13-mo follow-up.