PET/CT Utilization

 

Brain Tumor

  • Diagnosing, characterizing and grading before treatment
  • Diagnosing, characterizing and grading of possible recurrence
  • Assessing the extent of tumor for treatment planning
  • Excluding brain metastatic disease
  • Differentiating benign from malignant tumors
  • Directing biopsy
  • Monitoring treatment response
  • Differentiating recurrence from radiation necrosis or scar tissue

Source: Atlas of Clinical Positron Emission Tomography by Sallie F. Barrington, Michael N. Maisey and Richard R. Wahl. Oxford University Press, Inc. New York, NY. 2006.

 

Cervical Cancer

  • Routine staging and follow-up for detection of extrapelvic metastatic disease
  • Detecting recurrence and differentiating between recurrent tumor and post-treatment fibrosis or necrosis
  • Retroperitoneal lymph node staging
  • Evaluating response to treatment

Source: Atlas of Clinical Positron Emission Tomography by Sallie F. Barrington, Michael N. Maisey and Richard R. Wahl. Oxford University Press, Inc. New York, NY. 2006.

 

Colorectal Cancer

  • Detecting of tumor recurrence in patients with rising levels of serum CEA and otherwise normal radiographic studies
  • Determining if a radiological abnormality is a resectable recurrence, its true extent, and if it has metastasized elsewhere
  • Detecting intra-abdominal, hepatic or other metastases
  • Detecting extrahepatic metastases before a potentially curable hepatic resection
  • Evaluating efficacy of treatment such as chemotherapy and radiation
  • Evaluating response to treatment

Source: Atlas of Clinical Positron Emission Tomography by Sallie F. Barrington, Michael N. Maisey and Richard R. Wahl. Oxford University Press, Inc. New York, NY. 2006.

 

Esophageal Cancer

  • Detecting distant metastatic disease to abdominal lymph nodes, liver, lung, bone and adrenal glands
  • Determining resectability of disease
  • Distinguishing recurrent disease versus scar tissue after surgery
  • Evaluating patient response to treatment such as chemotherapy and radiation during the course of treatment
  • Determining efficacy of treatment regimen at completion of treatment

Source: Atlas of Clinical Positron Emission Tomography by Sallie F. Barrington, Michael N. Maisey and Richard R. Wahl. Oxford University Press, Inc. New York, NY. 2006.

 

Head and Neck Cancer

  • Locating some primary lesions not identified by conventional imaging
  • Detecting tumor metastases in normal sized lymph nodes
  • Staging for distant metastases or second primary lesion
  • Assessing treatment response and evaluating after surgery or radiation treatment
  • Detecting recurrent disease

 

Lung Cancer

  • Characterizing indeterminate pulmonary nodules and distinguishing malignant pulmonary nodules from benign ones.
  • Staging and restaging of non-small cell lung cancers, including mediastinal, lymph node, or distant metastatic disease.
  • Evaluating for recurrent disease and detecting residual tumor following definitive therapy.
  • Planning for radiotherapy treatment in nonsurgical patients.

Source: Atlas of Clinical Positron Emission Tomography by Sallie F. Barrington, Michael N. Maisey and Richard R. Wahl. Oxford University Press, Inc. New York, NY. 2006.

 

  • Lymphoma

  • Initial staging, in conjunction with other tests, CT, patient history, laboratory tests, bone marrow biopsy and tissue biopsy
  • Selecting optimal site for tissue biopsy
  • Assessing residual disease following therapy
  • Detecting recurrent disease following therapy
  • Evaluating efficacy of treatment during the course of planned chemotherapy

Source: Atlas of Clinical Positron Emission Tomography by Sallie F. Barrington, Michael N. Maisey and Richard R. Wahl. Oxford University Press, Inc. New York, NY. 2006.

 

Melanoma

  • Preoperative staging for patients with clinically suspected lymph node involvement, or symptoms suspicious for distant metastases
  • Preoperative staging for patients who have a high risk of systemic metastasis based on extensive locoregional tumor
  • Preoperative staging in patients with known metastasis who may benefit from resection
  • Postsurgical and restaging follow-up of patients at high risk for spread

Note: The sensitivity of PET/CT for detecting regional lymph node involvement is low due to micrometastatic disease which is too small to detect. Evaluation of local and regional lymph node metastases is performed by sentinel node mapping and biopsy.

Source: Atlas of Clinical Positron Emission Tomography by Sallie F. Barrington, Michael N. Maisey and Richard R. Wahl. Oxford University Press, Inc. New York, NY. 2006.

 

Metastatic Bone Disease

  • Identifying skeletal metastases in patients with a range of primary tumors
  • Performing initial evaluation and staging of metastatic disease in the skeleton
  • Localizing metastatic bone disease
  • Characterizing benign or malignant lesions in patients at risk for bone metastases
  • Assessing response of skeletal metastases to therapy
  • Detecting skeletal metastases during follow-up
  • Detecting primary tumors of the bone and identifying sites of disease
  • Assessing response to therapy in primary bone tumors
  • Detecting recurrent disease in primary bone tumors

Source: Grant. 2008. Skeletal PET with 18F-Fluoride: Applying New Technology to an Old Tracer JNM 2008; 49(1):68-78.

 

Ovarian Cancer

  • Identifying primary tumor, except small stage I cancers
  • Detecting peritoneal metastatic disease, except very small peritoneal implants
  • Guiding surgical debulking, for removal of cancerous tissue before chemotherapy
  • Evaluating patients with suspected recurrent disease with rising CA-125 and negative CT scan

Source: Atlas of Clinical Positron Emission Tomography by Sallie F. Barrington, Michael N. Maisey and Richard R. Wahl. Oxford University Press, Inc. New York, NY. 2006.

 

Thyroid Cancer

  • Determining if thyroid cancer has recurred
  • Precisely localizing iodine-negative metastatic disease in thyroid cancers that are producing thyroglobulin
  • Characterizing primary masses identified as part of a whole-body study for cancer imaging

Source: Atlas of Clinical Positron Emission Tomography by Sallie F. Barrington, Michael N. Maisey and Richard R. Wahl. Oxford University Press, Inc. New York, NY. 2006.

 

Urinary Tract Cancer

  • Determining the stage of urinary tract cancer
  • Detecting local or systemic metastatic disease
  • Evaluating treatment and detecting recurrent disease

Source: Atlas of Clinical Positron Emission Tomography by Sallie F. Barrington, Michael N. Maisey and Richard R. Wahl. Oxford University Press, Inc. New York, NY. 2006.

 

Positron Emission Tomography: Basic Science and Clinical Practice. Peter E. Valk, Dale L. Bailey, David W. Townsend, Michael N. Maisey. Springer-Verlag London Limited. 2003.

 

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