PET/CT

The PET/CT scanner from Philips is a hybrid system consisting of the newest generation Positron Emission Tomograph with ca. 18.000 GSO single crystal detectors made of germanium orthosilicate and a rapid multi-detector spiral CT with a minimal slice thickness of 0,5mm.

As the scanner has an open design and an internal radius of 70 cm as well as being able to carry a maximum weight of 195 kg, it is suitable for heavier individuals and anyone suffering from claustrophobia.

The MDCT is like a normal CT applicable to all medical questions.

The 'work horse' of the PET/CT is the examination with ¹⁸F-FDG (fluordesoxyglucose), a radioactively labelled modified glucose which enters cells with increased glucose metabolism (metabolic trapping). This substance is licensed as a medical drug.

In special cases, and on the basis of an individualised clinical trials (according to § 4 AMG - German medical drug legislation), we can perform examinations with other tracers, such as

¹⁸F-Cholin (for bladder and prostate cancers)

¹⁸F-FET (fluorethyltyrosin, for brain tumors)

pure ¹⁸F-Fluor (to illustrate bone metabolism, comparable to a common bone scintigraphy

Common indications for PET/CT-examinations are:

solitary pulmonary nodule (SPN)	characterisation
Non-Small Cell Lung Cancer (NSCLC)	primary staging, diagnosis, staging, re-staging, according to guidelines
Oesophageal cancer	diagnosis, staging and re-staging, therapy response (35% reduction of the standardised uptake value - SUV)
Colorectal Cancer	tumour localisation with rising CEA values. Diagnosis, staging and re-staging
Pancreas	DD tumour / inflammation, particularly with lesions < 2cm
Lymphoma	diagnosis, staging and re-staging, 15% more sensitive than CT on its own; part of guideline for the aggressive lymphoma following the 2nd cycle
Malignant Melanoma (skin cancer)	diagnosis, staging esp. as of stadium III and re-staging (standard)
Breast Cancer	in addition to conventional imaging techniques for patients with systemic metastases or re-staging for patients with elevated tumour markers or known locoregional relapses or metastases, additional to conventional imaging for analysing therapeutic response for women with locally advanced or metastasised Mamma-Ca, in case a change of the therapy regime is under discussion. Axillary lymph nodes: PET negative Patients can undergo sentinel lymphnode excision instead of complete axillary revision (no lymph edema). NO primary diagnosis
Ovarial carcinoma	recurrent disease diagnosis, restaging
Prostate carcinoma	biochemical relapse after definitive treatment, diagnosis, undetermined PSA-increase, 18F-Cholin
Brain Tumours	differentiation residual/recurrent tumour vs. radiation necrosis
CUP-Syndrome	identification of the primary tumour
Head- and Neck tumours	(excepting CNS and thyroid gland) diagnosis, lymph node staging and re-staging
Thyroid Carcinoma	recurrent disease or residual tumour , in patients with follicular subtype - initial therapy: Thyroidectomy and ablative radio-iodine therapy with I-131 - displaying an elevated thyreoglobulin level of > 10 ng/dl and a negative I-131 whole body scan.