PET for the Evaluation of Solitary Pulmonary

reasonably shows, as the authors claim, that PET is more accurate thanCTin evaluating solitary pulmonary nodules. The data presented in the article, however, also address an even more controversial clinical issue, namely: what is the visual or standardized uptake value (SUV) cutoff for classifying a solitary pulmonary nodule as benign? The traditional teaching, supported by numerous early, pivotal studies, including several by the authors of this paper, is that nodules with an SUV less than 2.5 or whose activity appears visually to be less than or equal to that of the mediastinal blood pool can be considered benign with enough confidence to avoid an immediate biopsy; these nodules can safely be followed with CT (2,3). Recently, several groups have published data contradicting this principle (4), including evidence that any visually perceptible uptake by a pulmonary nodule is associated with a significant chance of malignancy (5). This contradictory evidence has lef