PET's Role in the Solitary Pulmonary Nodule Workup

Dedicated PET's superior sensitivity and lesion detection (as small as 6-9mm), provides a viable alternative to biopsy. PET offers:

Diagnostic accuracy: sensitivity/specificity 90%/92%.
Eliminates need for invasive biopsy.
Lower costs compared to invasive workup.
No morbidity riskÑbiopsy carries 25% risk of pneumothorax.
PET evaluates surgical candidacy.

History

61 year-old female with history of right lung cancer; resection in 1996. Presents with new mid-lung nodule August 2000. Biopsy-proven left lung cancer.

PET Diagnosis

Intense hypermetabolic activity involving the left upper lobe pulmonary nodule making this highly suspicious for malignancy. Remaining PET study negative for metastatic disease.

Comment

PET scan can evaluate lung nodule for cancer and establish surgical candidacy in one exam, without the biopsy risk of pneumothorax.