Solitary Bone Metastasis Appearing outside the Usual Range of FDG PET/CT in Stage III Lung Cancer: Is Total Body FDG PET/CT Imaging Mandatory?

Abstract

Nowadays, 18-fluorodeoxyglucose positron emission tomography (18-FDG/PET) and computed tomography (CT) are frequently used in the diagnosis and staging of lung cancer. Usually, FDG-PET/CT images are taken from cranium or skull base to the groin, which covers most of the potential locations of metastasis. We describe three cases of stage IIIB NSCLC with unexpected stage-changing solitary bone metastasis outside the usual range of FDG PET/CT. We discuss whether a total body PET/CT should be performed on a regular basis. In addition, we propose a practical solution that is applicable in each clinic, to assess the whole body "on demand", without compromising the logistics in a busy PET/CT clinic.