PMC6086101_01
First diagnosis with CT and PET of the chest.. Note: The image shows the primary lesion with a nodule in the right lung and another nodule in the left lung.
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A nodule in the upper posterior lobe of the contralateral lung, of 27 mm, was also identified (Figure 1).
PET at first staging.. Note: The images confirm the nodular lesions in both lungs as stage T3 N0 M1a.
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Stage of disease was T3 N0 M1a (Stage IV) according to American Joint Committee on Cancer (AJCC) seventh edition (Figure 2).
PET at first restaging after chemotherapy.. Note: The disease is downstaged with persistence of primary tumor in right lung: the stage is yT2 N0 M0.
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The disease was downstaged to yT2a N0 M0 (stage IB) due to disappearance of the two nodules (Figure 3).
CT/PET at second restaging after thoracic radiotherapy (66 Gy dose delivered).. Note: The findings of post-radiation pneumonitis and persistent disease are recorded.
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The PET after 3 months of radiotherapy showed a metabolically active right pulmonary lesion with avid FDG uptake (SUV 14) (Figure 4).
PET at last restaging after eight cycles of nivolumab.. Note: No fluorodeoxyglucose uptake and cavity with fibrosis in right lung is present, confirming a complete remission of disease.
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After eight cycles the new PET confirmed the complete resolution of the tumor, as well as no FDG uptake (Figure 5).