PET/CT in Oncologic Imaging of Nodal Disease: Pearls and Pitfalls: RadioGraphics Fundamentals | Online Presentation.
Radiographics. 2018 Mar-Apr;38(2):564-565. doi: 10.1148/rg.2018170143. Wallitt K1, Yusuf S1, Soneji N1, Khan SR1, Win Z1, Barwick TD1.
At conventional imaging, metastatic lymph node involvement is based on size criteria and morphology. For typically fluorine 18 fluorodeoxyglucose (FDG)–avid tumors, hybrid imaging with FDG positron emission tomography (PET)/computed tomography (CT) provides a functional assessment of lymph node metabolic activity, improving detection sensitivity and specificity. However, necrotic or cystic nodes may be falsely negative, and some tumors such as prostate cancer may demonstrate only low-level FDG activity.
Oncologic assessment of lymph node status is paramount in the patient pathway for accurate staging and selection of the appropriate therapeutic approach. Regional lymph node involvement is a core component of the TNM classification, which is available for most tumors. In addition, it can provide prognostic information in certain tumor types and help determine appropriate clinical management.