Fig. (3).

Small node metastasis (SUVmax 2.0; SUVmax liver 2.5) in patient with poorly differentiated adenocarcinoma with large cells of the left lung (G3). Nodes are likely to have metabolically similar cells within them to the primary lesion, and consequently, a small intensely avid node, even with an SUV value lower than liver SUV value, is more likely to be malignant. In patients with PET activity in a mediastinal lymph node and normal-appearing nodes by CT (and no distant metastases), an invasive staging of the mediastinum is recommended over staging by imaging alone. (A higher resolution / colour version of this figure is available in the electronic copy of the article).