We thank Lacout and colleagues [1] for their letter regarding our article [2]. We would agree that an 18F-FDG PET study fused with a good-quality CT study with IV iodinated contrast administration would be optimal for the assessment and staging of primary lung cancer given the lack of spatial resolution of PET.
Unfortunately, in our region the majority of the PET/CT studies are performed on a mobile van with no facility to administer IV contrast material. The patient would usually have undergone staging with IV contrast-enhanced CT of the thorax and upper abdomen before PET/CT.
Radiotherapy planning is usually performed with CT without IV contrast administration in our facility. We appreciate that FDG may give a false-positive result in cases of consolidation. However, our study showed that unenhanced CT is adequate for radiotherapy planning, and for some patients in the study, FDG PET was helpful where there was adjacent collapse or consolidation or the tumor was close to the mediastinum.

Footnote

WEB—This is a Web exclusive article.

References

1.
Lacout A, Marcy PY, Thariat J. Value of combined PET/contrast-enhanced high-resolution CT fusion imaging for lung cancer. (letter) AJR 2012; 198:[web]W99
2.
Pawaroo D, Cummings NM, Musonda P, Rintoul RC, Rassl D, Beadsmoore C. Non–small cell lung carcinoma: accuracy of PET/CT in determining the size of T1 and T2 primary tumors. AJR 2011; 196:1176–1181

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American Journal of Roentgenology
Pages: W100

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Davina Pawaroo
Norfolk and Norwich University Hospital, Norfolk, United Kingdom
Clare Beadsmoore
Norfolk and Norwich University Hospital, Norfolk, United Kingdom

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