Clinical PET/CT imaging

Summary:

PET/CT is now established as the most important imaging tool in oncology. PET/CT stages and restages cancer with a higher accuracy than PET or CT alone. The sometimes irrational approach to combine state of the art PET with the highest end CT devices should give way to a more reasonable equipment design tailored towards the specific clinical indications in well-defined patient populations. The continuing success of molecular PET/CT now depends more upon advances in molecular imaging with the introduction of targeted imaging probes for individualized therapy approaches in cancer patients and less upon technological advances of imaging equipment.

Zusammenfassung:

PET/CT ist heute die wichtigste onkologische Bildgebungsmethode. Mit PET/CT ist das Staging und Restaging genauer als mit PET oder CT allein. Der mitunter unsinnige Zwang, die Technologie eines modernen PET mit einer stetig aktualisierten CT-Technologie zu kombinieren, sollte durch eine vernünftige Kombination aus PET und CT ersetzt werden, die auf spezifische klinische Anforderungen in definierten Patientengruppen zugeschnitten ist. Der weitere Erfolg der molekularen PET/CT Bildgebung hängt weniger von technischen Upgrades, sondern vielmehr von Fortschritten in der molekularen Bildgebung ab, wobei die Einführung von spezifischen Markern für individualisierte onkologische Therapieansätze eine besonders wichtige Rolle spielt.

Key words:

PET/CT - cancer - diagnostic accuracy

Schlüsselwörter:

PET/CT - Onkologie - diagnostische Genauigkeit

• References

• 1 Beyer T, Townsend D, Brun T. et al. A combined PET/CT scanner for clinical oncology. J Nuc Med 2000; 41: 1369-79.
• 2 Charron M, Beyer T, Bohnen N. et al. Image analysis in patients with cancer studied with a combined PET and CT scanner. Clin Nucl Med 2000; 25: 905-10.
• 3 Kuhle W, Porenta G, Huang S. et al. Quantification of regional myocardial blood flow using 13N-ammonia and reoriented dynamic positron emission tomographic imaging. Circulation 1992; 86: 1004-17.
• 4 Huang S, Phelps M, Hoffman E. et al. Error sensitivity of the fluorodeoxyglucose method for measurement of cerebral metabolic rate of glucose. Cereb Blood Flow of Metabol 1981; 1: 391-401.
• 5 Weber W, Ziegler S, Thodtmann R. et al. Reproducibility of metabolic measurements in malignant tumors using FDG PET. J Nucl Med 1999; 40: 1771-7.
• 6 Goerres G, Kamel E, Heidelberg T. et al. PET-CT image co-registration in the thorax: Influence of respiration. J Nucl Med 2002; 29: 351-60.
• 7 Beyer T, Antoch G, Blodgett T. et al. Dual-modality PET/CT imaging: the effect of respiratory motion on combined image quality in clinical oncology. Eur J Nucl Med Mol Imaging 2003; 30: 588-96.
• 8 Jemal A, Clegg L, Ward E. et al. Annual report to the nation on the status of cancer, 1975–2001, with a special feature regarding survival. Cancer 2004; 101: 3-27.
• 9 Halpern BS, Dahlbom M, Auerbach MA. et al. Optimizing imaging protocols for overweight and obese patients: A lutetium orthosilicate PET/CT study. J Nucl Med 2005; 46: 603-7.
• 10 Halpern B, Dahlbom M, Quon A. et al. Impact of patient weight and emission scan duration on PET/ CT image quality and lesion detectability. J Nucl Med 2004; 45: 797-801.
• 11 Townsend DW. From 3-D positron emission tomography to 3-D positron emission tomography/ computed tomography: what did we learn?. Mol Imaging Biol 2004; 6: 275-90.
• 12 Schaefer NG, Hany TF, Taverna C. et al. Non- Hodgkin lymphoma and Hodgkin disease: Coregistered FDG PET and CT at staging and restaging – Do we need contrast-enhanced CT?. Radiology 2004; 232: 823-9.
• 13 Antoch G, Freudenberg L, Beyer T. et al. To enhance or not to enhance? ¹⁸F-FDG and CT contrast agents in dual-modality ¹⁸F-FDG PET/ CT. J Nucl Med 2004; 45: 56S-65S.
• 14 Beyer T, Antoch G, Bockisch A. et al. Optimized intravenous contrast administration for diagnostic whole-body ¹⁸F-FDG PET/CT. J Nucl Med 2005; 46: 429-35.
• 15 Yau Y-Y, Chan W-S, Tam Y-M. et al. Application of intravenous contrast in PET/CT: Does it really introduce significant attenuation correction error?. J Nucl Med 2005; 46: 283-91.
• 16 Hany T, Steinert H, Goerres G. et al. PET diagnostic accuracy: improvement with in-line PET-CT system: initial results. Radiology 2002; 225: 575-81.
• 17 Kamel E, Hany TF, Burger C. et al. CT vs 68Ge attenuation correction in a combined PET/CT system: evaluation of the effect of lowering the CT tube current. Eur J Nucl Med Mol Imaging 2002; 29: 346-50.
• 18 Allen-Auerbach M, Yeom K, Park J. et al. Standard PET/CT chest image acquisition during shallow breathing is inadequate for comprehensive staging of the lung in cancer patients. J Nucl Med 2005; Supplement.
• 19 Gambhir S, Czernin J, Schwimmer J. et al. A tabulated summary of the FDG-PET literature. J Nuc Med 2001; 42: 1S-71S.
• 20 Israel O, Yefremov N, Bar-Shalom R. et al. PET/ CT detection of unexpected gastrointestinal foci of ¹⁸F-FDG uptake: incidence, localization patterns, and clinical significance. J Nucl Med 2005; 46: 758-62.
• 21 Kamel EM, Thumshirn M, Truninger K. et al. Significance of incidental ¹⁸F-FDG accumulations in the gastrointestinal tract in PET/CT: correlation with endoscopic and histopathologic results. J Nucl Med 2004; 45: 1804-10.
• 22 Antoch G, Vogt FM, Freudenberg LS. et al. Wholebody dual-modality PET/CT and whole-body MRI for tumor staging in oncology. JAMA 2003; 290: 3199-206.
• 23 Antoch G, Saoudi N, Kuehl H. et al. Accuracy of whole-body dual-modality fluorine-18–2-fluoro- 2-deoxy-D-glucose positron emission tomography and computed tomography (FDG-PET/CT) for tumor staging in solid tumors: comparison with CT and PET. J Clin Oncol 2004; 22: 4357-68.
• 24 Bar-Shalom R, Yefremov N, Guralnik L. et al. Clinical performance of PET/CT in evaluation of cancer: additional value for diagnostic imaging and patient management. J Nucl Med 2003; 44: 1200-9.
• 25 McKenna R, Libshitz H, Mountain C. et al. Roentgenographic evaluation of mediastinal lymph nodes for pre-operative assessment in lung cancer. Chest 1985; 88: 206-10.
• 26 Dwamena B, Sonnad S, Angobaldo J. et al. Metastases from non-small cell lung cancer: mediastinal staging in the 1990s – meta-analytic comparison of PET and CT. Radiology 1999; 213: 530-6.
• 27 Lardinois D, Weder W, Hany T. et al. Staging of non-small-cell lung cancer with integrated positron- emission tomography and computed tomography. N Engl J Med 2003; 348: 2500-7.
• 28 Antoch G, Stattaus J, Nemat A. et al. Non-small cell lung cancer: dual-modality PET/CT in preoperative staging. Radiology 2003; 229: 526-33.
• 29 Halpern B, Schiepers C, Weber W. et al. Pre-surgical staging of non-small cell lung cancer: PET, integrated PET/CT and software image fusion. Chest. 2005 (in press).
• 30 Keidar Z, Haim N, Guralnik L. et al. PET/CT Using ¹⁸F-FDG in suspected lung cancer recurrence: diagnostic value and impact on patient management. J Nucl Med 2004; 45: 1640-6.
• 31 Zimmer L, Snyderman CH, Fukui M. et al. The use of combined PET/CT for localizing recurrent head and neck cancer: the Pittsburgh experience. Ear Nose Throat J 2005; 84: 108-10.
• 32 Branstetter IV BF, Blodgett TM, Zimmer LA. et al. Head and neck malignancy: Is PET/CT more accurate than PET or CT alone?. Radiology 2005; 235: 580-6.
• 33 Schoder H, Yeung HWD, Gonen M. et al. Head and neck cancer: clinical usefulness and accuracy of PET/CT image Fusion. Radiology 2004; 231: 65-72.
• 34 Fueger B, Weber W, Quon A. et al. Performance of ¹⁸F-FDG PET and Integrated PET/CT in Restaged Breast Cancer Patients. Mol Imaging Biol. 2005 (in press).
• 35 Allen-Auerbach M, Quon A, Weber WA. et al. Comparison between 2-deoxy-2-[¹⁸F]fluoro- D-glucose positron emission tomography and positron emission tomography/computed tomography hardware fusion for staging of patients with lymphoma. Mol Imaging Biol 2004; 6: 411-6.
• 36 Freudenberg LS, Antoch G, Schutt P. et al. FDGPET/ CT in re-staging of patients with lymphoma. Eur J Nucl Med Mol Imaging 2004; 31: 325-9.
• 37 Bar-Shalom R, Guralnik L, Tsalic M. et al. The additional value of PET/CT over PET in FDG imaging of oesophageal cancer. Eur J Nucl Med Mol Imaging. 2005 (in press).
• 38 Cohade C, Osman M, Leal J. et al. Direct comparison of ¹⁸F-FDG PET and PET/CT in patients with colorectal carcinoma. J Nucl Med 2003; 44: 1797-803.
• 39 Kamel IR, Cohade C, Neyman E. et al. Incremental value of CT in PET/CT of patients with colorectal carcinoma. Abdominal Imaging 2004; 29: 663-8.
• 40 Kim J-H, Czernin J, Allen-Auerbach MS. et al. Comparison between ¹⁸F-FDG PET, In-Line PET/ CT, and software fusion for restaging of recurrent colorectal cancer. J Nucl Med 2005; 46: 587-95.
• 41 Even-Sapir E, Parag Y, Lerman H. et al. Detection of recurrence in patients with rectal cancer: PET/ CT after abdominoperineal or anterior resection. Radiology 2004; 232: 815-22.
• 42 Selzner M, Hany TF, Wildbrett P. et al. Does the novel PET/CT imaging modality impact on the treatment of patients with metastatic colorectal cancer of the liver?. Ann Surg 2004; 240: 1027-36.
• 43 Stroobants S, Goeminne J, Seegers M. et al. ¹⁸FDG-positron emission tomography for the early prediction of response in advanced soft tissue sarcoma treated with imatinib mesylate (Glivec). Eur J Cancer 2003; 39: 2012-20.
• 44 Goerres GW, Stupp R, Barghouth G. et al. The value of PET, CT and in-line PET/CT in patients with gastrointestinal stromal tumours: long-term outcome of treatment with imatinib mesylate. Eur J Nucl Med Mol Imaging 2005; 32: 153-62.
• 45 Antoch G, Kanja J, Bauer S. et al. Comparison of PET, CT, and dual-modality PET/CT imaging for monitoring of imatinib (STI571) therapy in patients with gastrointestinal stromal tumors. J Nucl Med 2004; 45: 357-65.