FDG PET: advantages for staging the mediastinum?

Correctly staging lung cancer is extremely important because treatment options and prognosis differ significantly by stage. In this review, the performance characteristics of positron emission tomography using F-18-fluoro-deoxyglucose (FDG PET) for staging the mediastinum are given in comparison with other non-invasive imaging modalities on the basis of current literature data. There are three meta-analyses demonstrating that FDG PET is more accurate than CT for detecting mediastinal metastases. First publications suggest that dual-modality PET-CT may provide a further gain in accuracy. Additionally, whole-body FDG PET provides information on M-staging and prognosis. Data comparing FDG PET with other functional imaging modalities or endoscopic ultrasound are limited. The necessity of a histological confirmation of PET results is still under discussion.