[A surgeon's view on the importance of positron emission tomography--PET (with emphasis on lung neoplasms)]. / Pohled chirurga na význam pozitronové emisní tomografie--PET (se zamerením na plicní nádorové postizení).

OBJECTIVE: PET became a successful method in preoperative evaluation of patients with cancer. We question whether PET scan can answer critical surgeons' requests such as distinguish benign and malign lesions, evaluation of cancer dissemination, evaluation of the pleural effusions, and also to detect early cancer recurrence. METHODS: Between September 1999 and December 2001, 39 patients underwent a PET scan and we evaluated its benefit in further treatment of patients. Standard PET techniques were used. RESULTS: In 20 patients (52%) results of PET scan were in correlation of clinical diagnosis and stage of cancer disease, partial difference between FDG-PET and clinical diagnosis was in 8 patients (20%), next treatment was changed in 11 patients (28%). CONCLUSION: We conclude, that dedicated PET could be valuable tool in the diagnosis and staging of cancer disease, especially in verifying cancer dissemination, recurrence of the cancer. PET scan can be misleading in evaluation of the mediastinal lymphnodes and pleural effusions.

Metabolic characterisation of solitary pulmonary nodules by positron emission tomography with FDG--preliminary report.

BACKGROUND: In the past some authors evaluated FDG-PET as a powerful tool for non-invasive assessment of malignancy of solitary pulmonary nodules (SPN). The aim of this paper is to verify the performance of positron emission tomography with fludeoxyglucose (FDG-PET) in SPN in the conditions of the Czech Republic during the first 16 months of the operation of the PET Centre Prague. MATERIAL AND METHODS: The group of 22 patients with 23 SPN was investigated by dedicated PET scanner due to inconclusive CT scan. Micromorphological confirmation was available in 61%; follow-up (median = 12 months) concerned the other 39% SPN. RESULTS: PET was clearly positive in 11 nodules, all were malignant according to micromorphological assessment. PET was completely negative in 10 nodules, 3 of them were micromorphologically evaluated as benign, the other 7 nodules were followed up without any signs of malignancy. In two cases, PET revealed enhanced glucose consumption, but the pattern was not typical for malignancy. These cases were considered as bronchopneumonia, but till now, they have not been definitely resolved. CONCLUSIONS: Excluding two unresolved cases, sensitivity and specificity of FDG-PET was 100% for malignancy in our series. PET was helpful in medical decision-making in all patients.