Positron emission tomography in the management of non-small cell lung cancer

In the past 10 years, positron emission tomography (PET) has become an important imaging modality in non-small cell lung cancer (NSCLC). Current indications for PET in the staging of newly diagnosed NSCLC are mainly the patients who are considered to be candidates for radical treatment. PET also has prognostic value; it can be used for the evaluation of response or restaging after radiotherapy or chemotherapy and for early detection of relapse. The combination of CT and PET improves radiotherapy planning, and it is expected that combined CT-PET-guided planning devices will further refine three-dimensional conformal radiotherapy. A whole new field of application of PET in molecular biology using new radiopharmaceutics is in development. It is hoped that PET examinations with new molecular tracers will allow ever better specificity and become sufficiently reliable and manageable so that very early response monitoring during chemotherapy or radiotherapy, evaluation of novel molecular-targeted lung cancer therapies, or even gene therapy becomes possible.