The role of PET in the evaluation, treatment, and ongoing management of lung cancer

PET is central to the diagnosis and staging of lung cancer. The transition to dose-escalate radiation with increasingly selective nodal radiation has made the accurate characterization of nodal status critical to successful treatment. Although mediastinoscopy increases the detection of microscopic nodal metastasis to a greater extent than PET alone, treatment failure in omitted elective nodal areas is rare with PET-guided modern chemoradiation. New horizons for PET scanning include the ability to potentially allow for early detection of salvageable poor treatment responses or local recurrence, as well as to improve the molecular blueprint of tumors with novel tracers to assist with treatment selection and delivery of targeted therapy. The role of PET imaging in the management of lung cancer is likely to continue to increase in the future.