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Positron Emission Tomography In Oncology

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POSITRON EMISSION TOMOGRAPHY IN ONCOLOGY F De Winter, C Van de Wiele, RA Dierckx Ghent University and University Hospital, Belgium
POSITRON EMISSION TOMOGRAHY ,[object Object],[object Object],[object Object]
NUCLEAR MEDICINE : DIAGNOSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Radiopharmaceutical (eg FDG) electron 511 keV gamma ray 511 keV gamma ray positron positron + electron = 2 * 511 Kev (180°)
BABY CYCLOTRON
POSITRON EMISSION TOMOGRAHY SYSTEM
18 FLUORINE BONE PET
18 FLUORO DEOXYGLUCOSE (FDG)
FDG UPTAKE MECHANISM
NORMAL FDG PET SCAN
 
REIMBURSEMENT FOR FDG PET IN BELGIUM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
REIMBURSEMENT FOR FDG PET ,[object Object],[object Object],[object Object],When other imaging modalities are not conclusive...
REIMBURSEMENT FOR FDG PET ,[object Object],[object Object],[object Object],[object Object],When other imaging modalities are not conclusive...
REIMBURSEMENT FOR FDG PET ,[object Object],[object Object],[object Object],[object Object]
 
LOCOREGIONAL RESTAGING : BRAIN TUMOR RECURRENCE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
LOCOREGIONAL RESTAGING : HEAD AND NECK CANCER
POSSIBLE PET INDICATIONS FOR HEAD AND NECK CANCER ,[object Object],[object Object],[object Object],[object Object]
HEAD AND NECK CANCER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HEAD AND NECK CANCER : II LOCAL RECURRENCE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HEAD AND NECK CANCER : LOCAL RECURRENCE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HEAD AND NECK CANCER CLINICAL STUDY ,[object Object],[object Object]
HEAD AND NECK CANCER CLINICAL STUDY ,[object Object],[object Object],[object Object],[object Object]
 
RESTAGING OF LYMPHOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RESTAGING OF LYMPHOMA ,[object Object],[object Object],[object Object],[object Object]
LYMPHOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
RESTAGING OF OVARIUM CARCINOMA ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
COLORECTAL CARCINOMA : RESTAGING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COLORECTAL CARCINOMA : RESTAGING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COLORECTAL CARCINOMA : RESTAGING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
STAGING OF LUNG CARCINOMA ,[object Object],[object Object],[object Object]
LUNG CARCINOMA : I SOLITARY PULMONARY NODULE DIFFERENTIAL DIAGNOSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SOLITARY PULMONARY NODULE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SOLITARY PULMONARY NODULE gold standard histology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SOLITARY PULMONARY NODULE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DIFFERENTIAL DIAGNOSIS OF SOLITARY PULMONARY NODULES
SOLITARY PULMONARY NODULES: CONCLUSIONS (Rigo et al) ,[object Object],[object Object],[object Object],[object Object],[object Object]
LUNG CANCER ,[object Object],[object Object],[object Object],[object Object],[object Object],Therapy/prognosis depends on TNM stage
LUNG CANCER : II&III STAGING OF NSCLC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
STAGING OF NSCLC : N STAGING
STAGING OF NSCLC ,[object Object],[object Object],[object Object],[object Object]
NSCLC MEDIASTINAL STAGING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
STAGING OF NSCLC : N STAGING Van Steenkiste et al, Chest, 1997
STAGING OF NSCLC : N STAGING ,[object Object],[object Object],FDG-PET : high uptake in primary tumour but no focal abnormality in the mediastinum
STAGING OF NSCLC : M STAGING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
STAGING OF NSCLC : CONCLUSIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
STAGING MALIGNANT MELANOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
STAGING PANCREAS TUMOR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
FDG PET: PRACTICALITIES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FDG PET: PRACTICALITIES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
TOWARDS … ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IMAGE FUSION : PET + CT
IMAGE FUSION
 
BREAST CARCINOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BREAST CARCINOMA, T ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BREAST CARCINOMA ,[object Object],[object Object],[object Object],[object Object],[object Object]
BREAST CARCINOMA, N axillary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BREAST CARCINOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BREAST CARCINOMA : DIAGNOSIS
BREAST CARCINOMA : NODAL STAGING
BREAST CARCINOMA : METASTASIS ? Bone scan suspicious; MRI doubtful; PET neg (TN)
HEAD AND NECK CANCER : I STAGING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
N STAGING: COMPARISON OF FDG PET WITH CONVENTIONAL STAGING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HEAD AND NECK CANCER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
HEAD AND NECK CANCER CLINICAL STUDY ,[object Object],[object Object],[object Object]
IMPORTANCE OF METABOLIC PREPARATION

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