Accurate staging of non-small cell lung cancer (NSCLC) is essential for subsequent treatment. This study was designed to evaluate the value of FDG-PET in detecting unexpected extrathoracic metastases (ETM) in patients with NSCLC qualifying for surgical treatment based on conventional staging. One hundred patients with stage IIIa or less were included and underwent clinical evaluation, chest and upper abdominal CT scan, mediastinoscopy, and routine laboratory tests. If clinical signs of EM were present additional diagnostic methods, were applied. A partial body FDG-PET was performed. All findings in the FDG-PET were confirmed histologically or radiologically. Unknown ETM were detected in 13 patients (14%) at 19 sites. Whole-body FDG-PET improves detection of unsuspected ETM in patients with NSCLC otherwise eligible for surgery. Fourteen percent of patients were understaged.

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