The addition of 4D-PET/CT is most likely to have an impact on those nodules initially classified as indeterminate on standard WB-PET/CT. In lesions classified as benign or malignant on standard WB-PET/CT the addition of a 4D-PET/CT is less likely to impact lesion classification.

While 4D-PET/CT does improve the measurement of the metabolic signal, it does not overcome inherent limitations of FDG in differentiating a malignant lesion from inflammatory processes, correct for partial volume effects or compensate for the low intrinsic FDG-avidity of some malignancies.