Is 18F FDG PET-CT cost effective in lung cancer?

Medical advances are often technology driven. One of the new technologies used in imaging is the positron emission tomography (PET)-computed tomography (CT) scanner, which combines the advantages of the functional imaging of PET with CT. This enables both functional and anatomical data to be acquired at the same time. However, such technology is expensive and not always widely available. In the assessment of patients suffering from non-small-cell lung cancer the only curative treatment is surgery or radical radiotherapy, but this is only possible if disease is limited to the affected lung and local nodes. Imaging with CT has not been reliable in determining disease load and many patients undergo futile thoracotomies, which are both expensive and also carry a significant morbidity. In this clinical scenario there is evidence that (18)F fluorodeoxyglucose PET-CT is the best discriminator of disease load and, if used in the correct clinical setting, will not only reduce the number of futile operations but also reduce costs.