The need of a clinically oriented reporting of 18F-FDG PET/CT in non-small cell lung cancer (NSCLC)

Purpose: In the present review, we aimed to underline the importance of a clinically oriented PET reporting through the discussion of critical aspects that affect the impact of PET in NSCLC patients. Methods: Cornerstones for PET reporting related to staging of NSCLC after the publication of the new 8th edition of TNM and emerging issues related to locally advanced disease, to restaging and to response evaluation to innovative therapies are listed and specifically commented. Results: 18F-FDG PET/CT imaging has a prominent role in NSCLC patients both prior to surgery and when evaluating for metastatic disease. The benefit is even most marked in patients at greater risk of distant metastases. In this framework, for patients with stage III, PET imaging has the potential to result in a stage-shift through the identification of asymptomatic occult distant metastases, thus highlighting unexpected stage IV patients. The final PET report is influenced by factors that lie outside the acquired images, from the clinical information available at the time of reporting to the capability of linking these clinical details to further decision-making especially in the settings of response to new therapies. Conclusion: A multidisciplinary approach to cancer patients has a significant impact in their management and outcome. A clinically-oriented report is needed to transfer the relevant information to the clinician to fully exploit PET potential in NSCLC.