PET Overview


PET stands for Positron Emission Tomography, which is a clinically proven imaging technique that assists in the diagnosis and management of many diseases, including, most recently, cancer.

PET allows a physician to examine large areas of the body in a single scanning session, producing images of human body functions unobtainable by other imaging techniques. These images capture biochemical processes, such as tissue glucose metabolism, that cannot be revealed by anatomical imaging with conventional X-ray, CT, or MRI.

By uncovering abnormalities that might otherwise go undetected, PET guides physicians to the most appropriate treatment. For example, PET may detect metastatic disease not evident clinically or through routine imaging, resulting in triage of the patient to a more appropriate course of therapy. PET may also demonstrate that abnormalities thought to be malignant, based on CT or MRI, are actually more likely to be benign, based on their level of metabolic activity.

Relevance to Cancer:

PET technology can help physicians answer the critical questions for many cancer patients in one exam:

  • Does a patient have cancer? Is a lesion benign or malignant?
  • Where is the cancer? Is it spreading?
  • What is the optimal therapy?
  • Is the therapy working?
  • Is there a recurrence of cancer?

Summary of Patient Benefits:

  • Potential increase in diagnostic confidence for patients suspected to have cancer, and those who already have the disease.
  • Potential reduction of invasive procedures such as biopsies and unnecessary surgeries.
  • Potential reduction in number of tests, since a single PET scan can sometimes substitute for a combination of other imaging tests.
  • Greater peace of mind for patients and their families, knowing that this technology provides more accurate information, in many cases, than that provided by other tests. This technology may also eliminate a "wait and see" approach, often used to monitor the patient after treatment.
  • Potential improvement in treatment follow-up, as PET often shows the effectiveness of a given therapy earlier and more accurately than other tests.

How Does PET Compare With Other Imaging Modalities?

Positron Emission Tomography (PET) is a specialized Nuclear Medicine imaging technique that provides physicians with unique diagnostic information that may alter patient management and reduce the total cost of patient care. It produces images of molecular-level physiological function that can be used to measure many vital processes, including glucose metabolism, blood flow, and oxygen utilization. With these images, physicians can identify normal and abnormal states. For oncologic applications, clinical PET in the U.S. is currently limited to the imaging of glucose metabolism, though other applications of PET are likely to be approved in the near future.

This exciting technology extends the capabilities of other advanced imaging modalities. Like MR and CT, for example, it uses proven tomographic computerized image generation techniques to display data as cross-sectional images in any plane. And like other Nuclear Medicine imaging tests, PET images represent the distribution within the body of small amounts of radioactive compounds specially designed to monitor physiologic processes.

But that's where PET's resemblance to other imaging modalities ends.

How is PET Unique?

Anatomical imaging modalities, such as CT and MR, are usually limited to evaluating the morphology of disease, such as whether a lesion is present or absent, or whether a lymph node is enlarged. But this anatomical picture often does not tell the whole story. In contrast, PET permits assessment of chemical and physiological changes related to metabolism. This is important because functional change often predates structural changes in tissues. PET images may therefore demonstrate pathological changes or changes due to response to therapy before they would be revealed by modalities like CT and MR.

Like traditional Nuclear Medicine imaging tests, PET uses unique compounds called radiopharmaceuticals, or "tracers", labeled with isotopes that allow a specialized camera to "trace" the distribution of those compounds in the body. Unlike most Nuclear Medicine tracers, the radiopharmaceuticals used in PET often stem from the basic elements of biological substrates. These PET tracers mimic natural substrates such as sugars, water, amino acids, nucleic acids, and oxygen. As a result, PET will often reveal more about the cellular-level metabolic status of a disease than other types of imaging modalities. Typically, the combination of the metabolic information provided by PET and the anatomic information from CT or MRI provides the optimal clinical answer.

PET also stands alone in its ability to quantify physiological and biochemical measurements in vivo. This is most important in research applications, but also provides certain advantages to the qualitative or semi-quantitative techniques employed in routine clinical PET studies.

Current applications

PET is already making critical contributions to more accurate and cost-effective patient management in three primary medical disciplines: oncology; cardiology; and neurology. As researchers use PET to explore the basic physiology underlying disease processes, additional clinical applications are likely to evolve.

Depending on the disease process, PET has unique capabilities that can often help physicians to:

  • Diagnose disease before structural changes become detectable with anatomical imaging techniques, potentially improving the prognosis;
  • Evaluate suspicious lesions detected on other exams, helping predict whether those lesions are benign or malignant;
  • Identify distant, occult metastases that may affect the course of treatment and, therefore, change patient management;
  • In some cases, replace multiple diagnostic procedures with a single exam;
  • Help predict the potential benefit of planned  surgical procedures, to eliminate those that won't benefit the patient, thus significantly reducing the cost of healthcare delivery and minimizing unnecessary morbidity for the patient;
  • Manage patient therapy by monitoring response to a given regimen and providing early feedback on its efficacy, helping to reduce or avoid the cost and potential complications of ineffective treatments or unnecessary hospitalization.















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