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Nuklearmedizin 2005; 44(S 01): S18-S23
DOI: 10.1055/s-0038-1625210
Original Articles
Schattauer GmbH

Clinical PET/CT imaging

Promises and misconceptionsPET/CT-Bildgebung in klinischer AnwendungVersprechen und Missverständnisse
J. Czernin
1   Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Center/Nuclear Medicine, David Geffen School of Medicine at UCLA, Los Angeles, USA
,
M. A. Auerbach
1   Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Center/Nuclear Medicine, David Geffen School of Medicine at UCLA, Los Angeles, USA
› Author Affiliations
Further Information

Publication History

Received: 06 June 2005

in revised form: 17 August 2005

Publication Date:
11 January 2018 (online)

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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.
    Google Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    Google Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    Google Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    Google Scholar
  • 19 Gambhir S, Czernin J, Schwimmer J. et al. A tabulated summary of the FDG-PET literature. J Nuc Med 2001; 42: 1S-71S.
    Google Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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).
    PubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    Google Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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).
    PubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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).
    PubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar