There is as yet no uniform system for detecting tumor-free or tumor-infiltrated SLNs in lung cancer with high levels of sensitivity and specificity. It will be easily understood that the development of a plausible and rational basic concept for this tumor type is extremely difficult.
With all this in mind, it is clear that any methods that make it possible to detect cancer-infiltrated lymph nodes already in the presurgical stage would be highly valuable with a view to treatment strategies. In addition, it must be said that preoperative N-staging is performed almost exclusively in NSCLC cases and only rarely in cases of SCLC (Fig. 4).
Fig. 4. Lung cancer with hilar and mediastinal lymph node metastases. The coronal PET image shows an area of focally increased metabolic activity in the upper lobe of the right lung (P). In addition, there are positive lymph nodes in the right hilar region and in the mediastinum (LN)
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