We retrospectively investigated the clinical usefulness of fluorodeoxyglucose positron emission tomography (FDG-PET) for evaluation of patients with limited-disease small-cell lung cancer (LD-SCLC) diagnosed by conventional staging procedures. Sixty-three patients received whole body FDG-PET scans after routine initial staging procedures. The findings of FDG-PET scans suggesting extensive-stage disease were confirmed by other imaging tests or by the patient's clinical course. FDG-PET scan findings indicated distant metastases in 6 of 63 patients. Metastatic disease was confirmed in five of these six patients (8%, 95% confidence interval: 3-18%). FDG-PET scan also detected regional lymph node metastases even in nine patients (14%) in whom computed tomography images had been negative, including contralateral lymph node metastasis in three patients. FDG-PET scan detected additional lesions in patients diagnosed as having LD-SCLC by conventional staging procedures. The therapeutic strategies were changed in 8% of patients based on the results of FDG-PET. FDG-PET scan is recommended as an initial staging tool for patients with this disease.
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