Whole body PET imaging

In whole-body PET imaging, scanning is performed at 5-7 bed positions to scan the intended axial length of the body. At each bed position, there is an overlap of 3-5 cm between scans of two bed positions. Why ... 

In whole-body PET imaging, the overlap of bed positions is larger in 3D... 

Whole-Body PET Imaging with 18F-FDG Physician s Directive... 

Valk PE, Abella-Columna E, Haseman MK, Pounds TR, Tesar RD, Myers RW, Greiss HB, Hofer GA (1999) Whole-body PET imaging with ( F]fluorodeoxyglucose in management of recurrent colorectal cancer. Arch Surg 134 503-511 discussion 511-513... 

Hoegerle et al. (32) proposed an interesting comprehensive whole-body PET imaging approach, whereby FDG and F-fluoride were administered in a single injection. This approach resulted in a sensitivity of 87% for the detection of bone metastases. Because of its superior diagnostic performance, F-fluoride imaging will, in the near fumre, emerge as a commonly used bone survey for patients with cancer. 

M. Lonneux, I. Borbath, M. Berliere, C. Kirkove, S. Pauwels, The place of whole-body PET FDG for the diagnosis of distant recurrence of breast cancer, Clin. Positron. Imaging 3(2) (2000) 45-49. 

Surti S, Karp J (2004) Imaging characteristics of a 3-dimensional GSO whole-body PET camera. J Nucl Med 45 1040-1049... 

Tumor imaging, positron emission tomography (PET) whole body Tumor imaging, positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization limited area (e.g., chest, head/neck)... 

Fig. 34.3. FDOPA images (CT on the left, fused images in the middle, and whole-body PET [MIP] on the right) of a patient after thyroidectomy for medullary thyroid carcinoma (6 years ago), actually presenting with elevated calcitonin levels. PET shows pathologically increased uptake in a normal sized cervical lymph node (upper row) and in two lesions within the thyroid bed Surgery confirmed local recurrence of MTC and lymph node metastasis in this patient. Calcitonin levels normalized following surgery...

Fig. 34.4. Ga-DOTA-TATE images (transversal slices of CT, PET, and image fusion) showing a small somatostatin-receptor-positive tumor within the pancreatic head, which was confirmed by surgery. Whole-body PET right MIP) shows no metastases of the tumor...

Hoegerle S, Nitzsche E, Altehoefer C et al. (2002) Pheochro-mocytomas detection with F DOPA whole body PET— initial results. Radiology 222 507-512 Hofmann M, Maecke H, Borner R et al. (2001) Biokinetics and imaging with the somatostatin receptor PET radioligand Ga-DOTATOC preliminary data. Eur J Nud Med 28 1751-7... 

Hoegerle S, JuengUng F, Otte A, Altehoefer C, Moser EA, Nitzsche EU. Combined FDG and [F-18]fluoride whole-body PET a feasible two-in-one approach to cancer imaging Radiology 1998 209 253-258. 

In 1998, the first PET/CT scanner, combining functional information with morphological information, was introduced by Townsend and co-workers [3], Combined PET/CT devices offer an efficient tool for whole-body staging and restaging functional assessment within one imaging modality. PET/CT scanners allow a merging of complementary information from CT and PET, leading to a more accurate anatomic localization. Furthermore, a more precise assessment of tumor volume is possible in comparison to PET. 

The combination of whole-body anatomical (CT) and functional (PET) imaging offers an efficient tool for whole-body staging, restaging and therapy control and functional assessment in one device. PET/CT enables the assessment of the exact tumor volume. Recently, studies evaluating the impact of [ F]-FDG-PET/CT on diagnosing and treating colorectal cancer have been published (Fig. 1) [28-31]. 

Schirrmeister et al. prospectively evaluated the clinical value of planar bone scans, SPECT and [ F]-labeled sodium fluoride in 53 patients with newly diagnosed lung cancer [193], Twelve of the 53 patients turned out to have bone metas-tases. [ F]-fluoride-PET detected all patients with bone metastases, whereas bone scan and SPECT produced false-negative results (6 vs. 1). An area under the curve analysis (ROC) proved p F]-fluoride-PET to be the most accurate whole-body imaging modality for screening of bone metastases in this study. 

D. Vranjesevic, J.E. Filmont, J. Meta, D.H. Silverman, M.E. Phelps, J. Rao, P.E. Valk, J. Czernin, Whole-body (18)F-FDG PET and conventional imaging for predicting outcome in previously treated breast cancer patients, J. Nucl. Med. 43 (2002) 325-329. 

Figure 13-9 shows PET whole-body images from patients s a cancer management modality. 

An important advantage of a CT transmission scan in the PET/CT system is that the scan data can be used for attenuation correction of PET emission images, obviating the need for a separate lengthy transmission scan in the dedicated PET system. The use of CT scans for attenuation correction reduces the whole-body scan time significantly. CT attenuation correction and fusion of CT and PET images are discussed in detail in Chap. 3. 

Figure 6.3. NEMA phantoms for PET performance tests, (a) This NEMA body phantom is used for evaluation of the quality of reconstructed images and simulation of whole body imaging using camera-based coincidence imaging technique, (b) This phantom is used for measuring scatter fraction, dead time, and random counts in PET studies using the NEMA NU 2-2007 standard, (c) Close up end of the sensitivity phantom, (d) Set of six concentric aluminum tubes used in phantom (c) to measure the sensitivity of PET scanners. (Courtesy of Data Spectrum Corporation, Hillborough, NC)...

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