October 19, 2020 — Personalized treatment options for patients with lung cancer have come a long way in the past two decades.
PET-CT combines positron emission tomography (PET) detectors and computed tomography (CT) into one imaging system.
Indeterminate lesion on PET/CT classified by PET/MRI for 53-y-old man with lung cancer. Contrast-enhanced CT (A), PET (B), and fused 18F-FDG PET/CT (C) images are displayed in comparison with contrast-enhanced T1-weighted MRI (D), PET, and fused 18F-FDG PET/MRI (F) images. In CT (A), hyperdense, subcentimeter liver lesion (arrows) in segment VII is suggestive of transient hepatic attenuation difference or small hemangioma. As malignancy cannot be excluded, it needs further investigation. On PET/MRI, lesion is clearly classified as metastasis because of contrast enhancement and tracer uptake due to later acquisition time point. Follow-up CT confirmed diagnosis after 78 d. Images created by Ole Martin, University Dusseldorf, Medical Faculty and Benedikt Schaarschmidt, University Hospital Essen.
a) Includes scintigraphy and PET with and without concomitant CT. b) Includes conventional radiography, dual-energy x-ray absorptiometry, fluoroscopy, and radiography performed during radiologic interventions. c) Includes general, cardiothoracic, maxillary, plastic, and orthopedic surgery and neurosurgery. d) Includes allergology, cardiology, geriatrics, general internal medicine, pulmonology, gastroenterology, and rheumatology. Image courtesy of American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)
PSMA PET/CT accurately detects recurrent prostate cancer in 67-year-old man. 18F-DCFPyL-PSMA PET/CT shows extensive, intensely PSMA-avid local recurrence in prostate (bottom row; solid arrow) in keeping with the known tumor recurrence in the prostate. Right: PET shows extensive, intensely PSMA-avid local recurrence in prostate (top row; solid arrow) and a solitary bone metastasis in left rib 2 (bottom row; dotted arrow). Image courtesy of Ur Metser, et al.
Total-body dynamic 18F-FDG PET imaging with the uEXPLORER scanner allows us to monitor the spatiotemporal distribution of glucose concentration in metastatic tumors in the entire body (a). As compared to a typical clinical standardized uptake value image (b), the parametric image of FDG influx rate (Ki) can achieve higher lesion-to-background (e.g., the liver) contrast. In addition to glucose metabolism imaging by Ki, total-body dynamic PET also enables multiparametric characterization of tumors and organs using additional physiologically important parameters, for example, glucose transport rate K1 (d), across the entire body. Image courtesy of G.B. Wang, M. Parikh, L. Nardo, et al., University of California Davis, Calif.
Representative maximum-intensity projection PET images of a healthy human volunteer injected with 64Cu-NOTA-EB-RGD at 1, 8, and 24 hours after injection. Axial MRI and PET slices of glioblastoma patient injected with 64Cu-NOTA-EB-RGD at different time points after injection. Image courtesy of Jingjing Zhang et al., Peking Union Medical College Hospital, Beijing, China/ Xiaoyuan Chen et al., Laboratory of Molecular Imaging and Nanomedicine, NIBIB/NIH, Bethesda, USA
PET/CT imaging showing uptake and retention of 86Y-NM600 (imaging agent) in immunocompetent mice bearing prostate tumors. PET imaging data was employed to estimate tumor dosimetry and prescribe an immunomodulatory 90Y-NM600 (therapy agent) injected activity. Image courtesy of R Hernandez et al., University of Wisconsin-Madison, WI.
Left: Total-body PET/CT in psoriatic arthritis: multiple joints affected, shoulders, elbows, wrists, knees, ankles and small joints of the hands/feet. Arrow: left wrist; arrowhead: right wrist. Middle: Total-body PET/CT in rheumatoid arthritis: multiple joints affected, right shoulder, small joints of the left hand. Arrowhead at the 4th proximal interphalangeal joint shows classic ring-like uptake pattern. Arrow on the foot images demonstrates the hammer toe deformity besides big toe arthritis. Right: Total-body PET/CT in osteoarthritis: affected joints include the left elbow, right knee (arrow) and right big toe (arrowhead). Image courtesy of YG Abdelhafez et al., University of California Davis, Sacramento, CA.
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)
Iva Speck, MD, explains research showing that novel, fully digital, high-resolution positron emission tomography/computed tomography imaging of small brain stem nuclei can provide clinicians with valuable information concerning the auditory pathway in patients with hearing impairment. The research is featured in The Journal of Nuclear Medicine (read more at http://jnm.snmjournals.org/content/current). Video courtesy of Iva Speck, University Hospital Freiburg, Germany.
This is a lung X-ray reviewed automatically by artificial intelligence (AI) to identify a collapsed lung (pneumothorax) in the color coded area. This AI app from Lunit is awaiting final FDA review and in planned to be integrated into several vendors' mobile digital radiography (DR) systems. Fujifilm showed this software integrated as a work-in-progress into its mobile X-ray system at RSNA 2019. GE Healthcare has its own version of this software for its mobile r=ray systems that gained FDA in 2019.