Correct!
1. 18FDG-PET
Among the choices listed, 18FDG-PET would be the most useful procedure as it has the ability to assess for metabolic activity within the lesion as well as the ability to detect potential sites of disease elsewhere within and outside the thorax. Right lateral decubitus chest radiography is primarily useful for detection and quantification of right pleural fluid (the dependent side of the thorax in this example) or for detection of left-sided pneumothorax (the non-dependent thorax in this example); neither are considerations for this patient. 68Ga-citrate scintigraphy again would not provide addition useful information in this patient. Video-assisted thoracoscopic surgery would be a useful procedure for obtaining a diagnosis for this patient, but there may be less invasive approaches to obtaining a diagnosis for this patient. Because the lesion appears complex and solid, thoracentesis is not an appropriate procedure for evaluation of this lesion.
The patient subsequently underwent 18FDG-PET scanning (Figure 6).
Figure 6. Axial 18FDG-PET.
Which of the following now represents the most likely diagnosis for this patient? (Click on the correct answer to proceed to the eighth of nine panels)