Nuclear imaging, also called molecular imaging, includes positron emission computed tomography (PET) and single photon emission computed tomography (SPECT) imaging. This section includes radiopharmaceuticals and tracers, PET-CT, SPECT-CT, and PET-MRI. Molecular imaging includes the field of nuclear medicine, which uses very small amounts of radioactive materials, or radiopharmaceuticals, to diagnose and treat disease.
Technological advancements in positron emission tomography/computed tomography (PET/CT) offer both clinicians and...
FIGURE: MRI AND PET-MRI FUSION IMAGES OF PATIENTS WITH DIPG. Top row: Zr-89-bevacizumab PET (144 hrs p.i.) fused with T1-Gd weighted MRI per patient; middle row: T1-Gd weighted MRI; lower row: T2-weighted/FLAIR MR-images. Five tumors show variable uptake of Zr-89-bevacizumab (white arrows), with both PET negative and positive areas within each tumor. Two primary tumors are completely PET negative (Fig. 1C and 1E), while the T2 weighted images show tumor infiltration in the whole pons of both patients. In the middle row, the red arrows represent the areas of contrast enhancement within the tumor. In four out of five primary tumors, the PET-positive area corresponds with the contrast-enhancing area on MRI of the tumors (Fig. 1A, 1B, 1F and 1G). In Fig. 1C, the tumor shows an MRI contrast-enhancing area, while there is no Zr-89-bevacizumab uptake. Fig. 1D shows a PET positive tumor, while no Gd-enhancement is observed on MRI. Credit: Sophie Veldhuijzen van Zanten and Marc Jansen, VU University Medical Center, Amsterdam, The Netherlands.
Staging F18FDG PET/CT images of adenocarcinoma in the RUL (right upper lobe) of the lung illustrates the value of Vereos. The primary lesion in the right upper lobe appears in the upper row (PET image is left, CT image is right). A 3 mm synchronous primary or metastatic lesion in the RUL is apparent in the lower row. The precision afforded by Vereos' images provided the basis for the patient to undergo RUL lobectomy instead of thermal ablation of the primary lesion. (Images courtesy of Dr. Jay Kikut and UVMC)
Efficiency and effectiveness are inseparable in clinical medicine. Digital PET addresses them both.
From left to right are patients with EGFR mutation, KRAS mutation, and EGFR– and KRAS– tumors, respectively. Stage I and III tumors are shown in the top and bottom rows, respectively. Arrows indicate the locations of the lung tumors. Credit: Stephen S.F. Yip, Ph.D., and Hugo Aerts, Ph.D., Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Harvard Medical School, Boston; John Kim, M.D., University of Michigan Health System, Ann Arbor, Mich.
CTVPOST (red) = CTVPRE (yellow) union CTVPET (pink). Also shown (upper right corner) are the PRE (square) vs POST (triangle) dose volume histograms for PTV1, PTV2, rectum, bladder, and penile bulb, showing minimal impact on target coverage or organs at risk dose with the modified targets. Image courtesy of Ashesh B. Jani, M.D., and David Schuster, M.D., Emory University.