A 59-year-old man was found to have a squamous cell lung carcinoma in his right upper lobe. He was a smoker and reported breathlessness on modest exertion. He also complained of chronic back pain.
Investigations:
forced expiratory rate in 1 s 3.2 L (83% predicted)
What is the most useful next investigation in assessing his suitability for surgical resection?
A: bone scan
B: bronchoscopy
C: cardiopulmonary exercise testing
D: PET-CT scan
E: ventilation/perfusion isotope lung scan
Correct answer: D Explanation PET scan is essential in accurate staging. It will show FDG uptake in lymph nodes and also may show distant metastases which would mean that the patient is not suitable for radical treatment. It is an essential investigation before surgical resection of lung cancer.