Interpretation of PET/CT scan
There are different methods for assessment of radiotracer uptake by normal and pathologic tissues, such as visual inspection, the standardized uptake value (SUV) and the glucose metabolic rate. Visual inspection in analysis of PET-CT results is used by comparing PET and CT data, as well as viewing fused PET-CT images. SUVs are used for semi-quantification of FDG uptake. Another method of quantification of dynamic PET results is the more complex glucose metabolic rate calculation (Kapoor et al, 2004).
Standardized Uptake Value
The SUV is a semi-quantitative assessment of the radiotracer uptake from a static (single point in time) PET image. The SUV of a given tissue is calculated with the following formula: SUV= tracer activity
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In addition to its physiologic accumulation in different organs, it can accumulate in non-neoplastic pathologic conditions, including infection, whether acute or chronic infection such as tuberculosis, granulomatous diseases such as sarcoidosis , and autoimmune disease such as Grave’s disease. In addition, the 18F-FDG uptake can be enhanced by inflammatory induced changes, which include post-operative healing scars and post-radiation therapy. A unique example of an inflammatory condition is the one caused by the atherosclerotic plaque formation that is associated with an abundance of macrophages known by its avidity to 18F-FDG. The degree of uptake is usually less than the uptake within the neoplastic tissues. However, there is clearly an overlap between the 2 conditions and, in some cases; the uptake could even exceed the neoplastic uptake. Furthermore; the image interpreter should be aware of a high accumulation of 18F-FDG in some benign tumors, such as giant cell tumor, fibrous dysplasia of the bone, and adenomatous polyps in the colon. Occasionally one will also see breast-related activity. Breast activity will be more obvious in lactating females (Abouzeid et al,
The photons are then tracked by a tomographic scintillation counter, and the information is processed by a computer to provide both image and data on blood flow and metabolic processes within bodily tissues. PET scans are particularly useful for diagnosing brain tumor and the effects of strokes on the brain, along with various mental illnesses. They are also used in brain research and in mapping of brain functions.
PET is the only method that can detect and display metabolic changes in tissue, distinguish normal tissue from those that are diseased, such as in cancer, differentiate viable from dead or dying tissue, show regional blood flow, and determine the distribution and
18F-FDG-PET can be used for detecting most types of lymphoma. However, even if the 18F-FDG-PET scan is positive in a pattern that is highly suggestive of lymphoma, diagnosis of lymphoma requires histological confirmation. The major utility of 18F-FDG-PET in diagnosis is often in directing a biopsy. PET can also be used to guide biopsies to the site of highest 18F-FDG uptake, representing the most aggressive site of lymphoma. 18F-FDG-PET may identify other involved regions, which can be biopsied at much lower morbidity (Delbeke et al, 2009).
Positron-Emission Tomography (PET) scan is a medical test that allows doctors to check the human body for any diseases. Doctors use the PET scan for many things, the main uses are checking for cancer, heart-related (Cardiovascular) diseases and brain (neurological) diseases. It also allows doctors to check organs and tissues and to see how they are working. PET scanners are a way of tracking diseases, using radioactive tracking that is injected into a vein in your arm, that is then absorbed by your organs and tissues.
Fat is normally present surrounding the viscera and will allow it to be more delineated on a radiograph, consequently it shows a contrast on the X-ray film for differentiation and visualization of many organs and structures (McKinnis, 2014; Lowe, n.d.; Stokell, n.d.). Water based tissues which include the soft tissues of the body and the fluid- filled organs are more radiodense than fat. Conventional radiographs have a limited value in evaluating soft tissue because their radiodensity approximates that of water and the variation in volume, thickness and degree of compactness of soft tissue creates a pattern of various densities on the radiograph (McKinnis, 2014; Lowe, n.d.; Stokell, n.d.). Lastly, bone is the most radiodense tissue of the body and best visualized on a radiograph. Bone is composed of calcium and phosphorous making them the whitest on radiographs, with the high calcium content of teeth being the whitest of all bone (McKinnis, 2014; Lowe, n.d.; Stokell,
In fact, medical imaging made it possible to identify diverse abnormalities in humans. These images can be obtained from Computed Tomography (CT), Magnetic Resonance Imaging (MRI), X-Rays, Ultrasound, positron emission tomography (PET), etc. Analyzing these images usually requires special programs and a user to run the software. All the images that are obtained, using different techniques, contain important and useful information for the physician to make a decision. MRIs are widely used by physicians and
Technetium-99m (99mTc) is the radiopharmaceutical used for pulmonary perfusion imaging (Leden, E. 1990). It localizes by the mechanism of capillary blockade. In general, less than 1 in 1000 (<0.1%) of the capillaries are blocked. In the absence of shunts, 95% of the particles are removed from the circulation on the first pass through the pulmonary capillary bed. About 5% of particles measure less than 5 μm in diameter and pass through the capillary system. For purposes of pulmonary perfusion imaging, it is important to use a sufficient number of particles to allow for good statistical distribution. In general, injection of a minimum of 100,000 particles and optimally between 200,000 and 600,000 particles is required (Leden, E. 1990).
The technology that is being investigated is the PET scan. The PET scan functions as a result of the specific atomic properties of positrons which are subatomic particles that have the opposite charge of electrons but the same mass. The PET scanner detects these positrons which are emanated by the radioactive chemicals attached to a chemical the body naturally metabolizes (Positron Emission Tomography, 2014). The PET scan is used in the fields of oncology, neurology, and cardiology to determine the flow of blood, the functionality of the organs, the health of heart tissue, the movement of cancer, and so forth (Positron Emission Tomography, n.d.). This technology works by inserting the patient with a radioactive material through injection,
Either for possible dose reduction or changes in clinical practice, evaluation of CT protocols is an important part of imaging management. Many institutions have undertaken dose reduction programs [1-9] which are now mandated by the latest Joint Commission [10], American College of Radiology [11, 12], Image Wisely [13], Image Gently [14], and the American Association of Physicists in Medicine guidelines [15, 16]. These programs evaluate whether the written protocols reflect the latest in our scientific understanding of what scanner parameters produce the lowest possible dose while still providing diagnostic images. These studies focus on the protocol design. The actual implementation of the protocols, however, has an important impact on whether
After reviewing the challenges, the CER staff faces in collecting data with their current paper-based patient monitoring form, the SNs, along with the stakeholders, decided that a new portable electronic based metabolic syndrome monitoring form should be created. Upon further review of the current form, it was discovered that many CER staff members did not have any actual training or guidelines in place in filling out the current form, nor any formal training in measuring blood pressure and abdominal circumference.
Positron emission tomograph (PET) is a medical imaging procedure that provides unique information about how an organ or system in the body is functioning. PET scans are mainly used to assess cancers, neurological diseases and cardiovascular disease. PET scan involves the injection of a small amount of a ‘positron-emitting’ radioactive material, often referred to as a radiopharmaceutical. Images of the body are then taken using a PET scanner. The camera used is able to detect emissions coming from the injected radiopharmaceutical. The specialised computer attached to the camera manipulates the image creating two and three-dimensional images of the area that is being examined. Areas where the injected radiopharmaceutical gathers appear much ‘brighter’
PET scan stands for positron emission tomography and is a type of nuclear imaging technique. The PET scan also measures the metabolic activities of the brain. It allows the doctors to check if there are diseases in the body. This scan uses radioactive tracers and radionuclide. The tracer is injected into the vain in our arm and is absorbed by the surrounding tissues which are picked by the scanner. The body will react to the tracer so that it can indicate the condition of the tissues. The PET scan can also measure blood flow, oxygen use, drug activity, glucose metabolism and tissue pH in the body. PET scans are commonly used to detect if the person has cancer, heart problems or brain disorders. Radionuclides which are used in the PET scan are
During the MRI, the patient can expect the same experiences they would for a PET or MRI scan separately. Although they’re integrated into one machine, they still have their own unique abilities. The exam is completed by a nuclear medicine technologist that has been trained in MRI as well. The patient will be injected with a radioactive isotope, just as they would for any other nuclear medicine study. The most common tracer used for PET is fluorodeoxyglucose (Asim, 2013). This tracer will reflect the glucose
As with any other radiographic method, optimum interpretable diagnostic images can only be achieved with careful quality assurance in patient positioning, in selecting appropriate exposure parameters and during processing.
employed radiotracer for PET is 18 F-fluorodeoxyglucose ( 18 F-FDG) (Scheme 1-2), which is a