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PET/CT Modality Combination

Positron Emission Tomography (PET) is a diagnostic imaging technique that evaluates physiological functions such as blood flow and metabolism, crucially aiding in oncology, cardiology, and neurology. It provides quantitative analyses and tracks disease progression or response to treatments. When combined with Computed Tomography (CT), it optimizes anatomical visualization and physiology assessment, although it requires careful protocol adherence. This article discusses PET/CT applications, staging protocols, and notable references for clinical guidelines in cancer treatment planning.

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PET/CT Modality Combination

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  1. PET/CT Modality Combination Clinical LOINC – Diagnostic Imaging PSWilson, February 14, 2013

  2. Positron Emission Tomography • “Is a technique that measures physiological function by looking at blood flow, metabolism, neurotransmitters, and radiolabelled drugs. PET offers quantitative analyses, allowing relative changes over time to be monitored as a disease process evolves or in response to a specific stimulus.​” • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1126321/

  3. Applications of PET • Cardiology • Oncology • Neurology

  4. Use of PET for Oncology • Metabolism and Physiology • Staging or Restaging of Cancer (not initial dx) • Prior to Chemo, Radiation Tx, or Surgery • Always full body • Always injection of FDG

  5. Computerized Tomography • Majority of imaging is Head/Torso or full body • Used as a complement to PET • May or may not have IV or Oral Contrast

  6. PET with CT • PET for physiology, CT for anatomy • 2 settings, different times, thus 2 reports • Problem with overlay due to repositioning • Current is a single unit • Same setting, same position • Single report

  7. Protocols for PET • Head and Thorax • Head/Neck Cancer • Whole Body • Breast • Melanoma • Sarcoma • Mid Skull to Thigh • Everything else

  8. Protocol for CT • With IV Contrast • Gastrointestinal (also Oral and/or Rectal) • Neuro • Endocrine • Without Contrast • Thyroid • Renal • Breast • With and Without IV Contrast • Lung

  9. LOINC Perspective • Observation is the same whether or not the images were obtained from a single or different machines • Rarely dictated as a separate report • Diagnosis is not pertinent (captured elsewhere in HL7 • Staging versus Re-staging (same protocol) • Separate CT report for any additional images for diagnostic purpose

  10. Proposed (Breast,Thyroid, Renal)

  11. References • http://www.ccsnm.org/pdfs/2010/protocols/PET-CT%20FDG%20Guidelines.pdf • http://bjr.birjournals.org/content/80/954/437.full • http://radiology.rsna.org/content/244/1/263.full • http://radiographics.rsna.org/content/27/suppl_1/S215.full • http://jnm.snmjournals.org/content/45/1_suppl/25S.full

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