PETを用いた肺癌画像診断と今後の展望

The presence of metastasis to lymph node and distant organ before lung cancer treatment has a great impact on the selection of an appropriate treatment strategy and on the prognosis. FDG-PET has been developed as a diagnostic imaging modality that can sensitively detect malignant lesions with accelerated glucose metabolism, and is now widely used not only for the stage diagnosis of lung cancer but also for the diagnosis of recurrence and evaluation of therapeutic effects. Chest CT is a common diagnostic imaging method for N-factor diagnosis, which is important in the diagnosis of lung cancer, but there are many false negatives. FDG-PET is considered to have a better ability to diagnose lymph nodes than CT, but nonspecific FDG accumulation of lymph nodes due to chronic inflammation of the hilum and mediastinum is often observed. Moreover, the presence of micro lymph node metastasis could reduce the ability of diagnosing lymph node metastasis. With the findings on FDG-PET, unexpected lymph node metastasis or distant metastasis may be found in clinical practices, and treatment plan may be changed. In recent years, the development and progress of PET devices such as total-body PET scanner have progressed, and dynamic imaging after FDG administration are in the spotlight. In this review article, I make an introduction for the research and future prospects aimed at clinical practical application, including my experiments.