Viohl Nathalie, Steinert Matthias, Werner Anke, Kühnel Christian, Freesmeyer Martin, Drescher Robert
Clinic of Nuclear Medicine, Jena University Hospital, 07743 Jena, Germany.
Clinic of Thoracic Surgery, Leipzig University Hospital, 04103 Leipzig, Germany.
J Clin Med. 2025 Jun 23;14(13):4449. doi: 10.3390/jcm14134449.
/: Lung cancer is one of the most prevalent malignant diseases in humans. Numerous studies have demonstrated the significance of [F]fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the staging of this condition. : The pictorial evaluation is based on a recent study comparing preoperative imaging with postoperative histopathological findings following thoracic surgery. It confirmed the value of PET/CT in assessing primary tumor extent and metastatic lymph node involvement; but also revealed discrepancies in primary tumor (T) and lymph nodes (N) classification in 25% and 14% of patients, respectively. : The aim of this pictorial review is to highlight and further analyze the causes of inaccurate staging, identify potential diagnostic pitfalls, and provide practical recommendations to help avoid misinterpretation of PET/CT findings. Additionally, the impact of the newly introduced ninth edition of the International Association for the Study of Lung Cancer (IASLC) primary tumor, lymph nodes, and metastasis (TNM) staging system for lung cancer is discussed. : In this pictorial review, we presented various sources of error in preoperative staging observed at our institution. Awareness of these potential pitfalls may aid in improving staging accuracy and distinguishing physiological or reactive (benign) processes from pathological findings.
肺癌是人类最常见的恶性疾病之一。众多研究已证实[F]氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在该疾病分期中的重要性。本图像分析基于一项近期研究，该研究比较了胸外科手术后的术前影像学检查与术后组织病理学结果。它证实了PET/CT在评估原发性肿瘤范围和转移性淋巴结受累情况方面的价值；但也分别在25%和14%的患者中发现了原发性肿瘤（T）和淋巴结（N）分类的差异。本图像综述的目的是突出并进一步分析分期不准确的原因，识别潜在的诊断陷阱，并提供实用建议以帮助避免对PET/CT结果的错误解读。此外，还讨论了新引入的国际肺癌研究协会（IASLC）肺癌原发性肿瘤、淋巴结和转移（TNM）分期系统第九版的影响。在本图像综述中，我们展示了在我们机构观察到的术前分期中各种误差来源。认识到这些潜在陷阱可能有助于提高分期准确性，并将生理或反应性（良性）过程与病理结果区分开来。
