Figure 3.

Equivocal enlargement of mediastinal lymph nodes on diagnostic CT usually requires mediastinal lymph node sampling by various approaches including mediastinoscopy. These add to the cost and potential morbidity of the staging process. By identifying nodes that are more likely to be involved based on increased FDG uptake, and particularly more easily accessed, PET may improve the selection of the best nodal sites to sample in order to confirm, or exclude, metastatic involvement. In this case extrathoracic non-small cell lung cancer was confirmed by ultrasound-guided biopsy on a neck node identified on PET/CT and thus the patient was spared a surgical procedure.