PET and SPECT in the management of lung cancer

Lung cancer is the leading cause of cancer deaths in men and women. Most recently in 2001, the Health Care Financing Administration has expanded Medicare coverage for positron emission tomography (PET) to include the diagnosis, staging, and restaging of lung cancer. This review discusses the current metabolic imaging techniques, including the role of PET, single-photon emission computed tomography (SPECT), and the new hybrid PET in the diagnosis, staging, and treatment of lung cancer. The technological advantages, disadvantages, and benefits are compared. PET has the highest detection efficiency than gamma camera based devices. PET when merged with computed tomography (CT) forms the powerful hybrid PET-CT system, capable both of metabolic and anatomic imaging. Clinical imaging pathways based on these newer modalities for the management of lung cancer are proposed. Technological advances in metabolic imaging linked with therapy driven protocols and outcomes may further provide cutting edge modalities that positively impact on dismal lung cancer mortality statistics.