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PET/CT in hematological diseses
- 1. PET/CT scan in Managementof Hematological Disorders 6/5/2020
- 2. By Eman Aboelenein Assistant lecturerof Heamato- oncology Internal Medicine Department Faculty of Medicine Tanta University June 5, 2020
- 3. Agenda What isP.E.T? What is a Positron? How does P.E.T works? Uses. Risks and limitations. In Hematological Disorders Take Home Message 6/5/2020
- 4. What is PET •PET is a noninvasive, diagnostic imaging technique for measuring the metabolic activity of cells in the human body. • It was developed in the mid 1970s and it was the first scanning method to give functional information about the brain. 6/5/2020 Htt://www.nucmed.buffalo.edu/petdef.htm
- 5. Whole-body PET scanusing 18F-FDG: The normal brain and kidneys are labeled, and radioactive urine from breakdown of the FDG is seen in the bladder. In addition, a large metastatic tumor mass from colon cancer is seen in the liver. 6/5/2020
- 6. What is aPositron? • A Positron is an anti-matter electron, it is identical in mass but has an apposite charge of +1. • Positron can come from different number of sources, but for PET they are produced by nuclear decay. 6/5/2020 .
- 7. Annihilation of a positronand electron: 6/5/2020 .
- 9. How do wedetect photons (gamma rays)? 6/5/2020
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- 12. Uses: • Neuroimaging • Cardiology •Oncology • Infectious Diseases • Pharmacokinetics • Musculo-skeletal imaging 6/5/2020 Htt://www.nucmed.buffalo.edu/petdef.htm
- 13. Neuroimaging • Memory disordersof an undetermined cause. • Suspected or proven brain tumors • Seizure disorders that are not responsive to medical therapy and are therefore candidates for surgery. • Alzheimer’s disease • paraneoplastic neurological disorders. 6/5/2020 http://www.radiologyinfo.org/content/petomography.htm
- 14. Normal brain Imageof the brain of a 9 year old female with a history of seizures poorly controlled by medication. PET imaging identifies the area (indicated by the arrow) of the brain responsible for the seizures. Through surgical removal of this area of the brain, the patient is rendered "seizure-free". Htt://www.nucmed.buffalo.edu/petdef.htm 6/5/2020
- 15. Cardiology • Coronary arterydisease. • Myocardial infarction. 6/5/2020 http://www.radiologyinfo.org/content/petomography.htm The arrow points to areas that have been damaged by the attack, indicating "dead" myocardial tissue. Normal heart
- 16. Oncology • Diagnosis, staging,and monitoring treatment of cancers, particularly in Hodgkin's lymphoma, non-Hodgkin lymphoma, and lung cancer. • Also, FDOPA PET/CT (or F-18-DOPA PET/CT), localizing, pheochromocytoma than the MIBG scan 6/5/2020 http://www.radiologyinfo.org/content/petomography.htm
- 17. Image showing malignantbreast mass that was not revealed by conventional imaging techniques such as CT, MRI, and mammogram. Image of same patient with enlarged left axillary lymph nodes (indicated by arrows), which through biopsy were found to be metastatic (spread from another location). The whole body scan reveals a mass in the left breast (indicated by arrow), that was malignant and subsequently removed. Htt://www.nucmed.buffalo.edu/petdef.htm 6/5/2020
- 18. What are therisks? • Because the radioactivity is very short-lived, your radiation exposure is low. • The substance amount is so small that it does not affect the normal processes of the body. • The radioactive substance may expose radiation to the fetus in patients who are pregnant or the infants of women who are breast-feeding. 6/5/2020 http://www.radiologyinfo.org/content/petomography.htm
- 19. Limitations • PET cangive false results if a patient's chemical balances are not normal. diabetic patients or patients who have eaten within a few hours prior to the examination. 6/5/2020 http://www.radiologyinfo.org/content/petomography.htm
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- 31. • The Deauville5-point scoring system for the FDG avidity of a Hodgkin’s lymphoma or Non-Hodgkin’s lymphoma tumor mass as seen on PET scan: 6/5/2020
- 32. Score 1: Nouptake above the background. Score 2: Uptake ≤ mediastinum. Score 3: Uptake > mediastinum but ≤ liver. Score 4: Uptake moderately increased compared to the liver at any site. Score 5: Uptake markedly increased compared to the liver at any site. Score X: New areas of uptake unlikely to be related to lymphoma. 6/5/2020
- 34. • Scores of1 and 2 are considered to be negative • 4 and 5 are considered to be positive. • Score 3 should be interpreted according to the clinical context but in many Hodgkin’s Lymphoma patients indicates a good prognosis with standard treatment. 6/5/2020
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- 48. Summary for PETin Lymphoma • In Diagnosis, Staging. • Directing site of lymph node Biopsy. • Selecting therapy. • Early Evaluation of treatment. • Post chemotherapy evaluation of treatment. • Follow up and Detection of Relapse. 6/5/2020
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- 53. Summary of PETin Myeloma • Extramedullary lesions. • Solitary plasmacytoma from MM. • Smouldering MM. • Follow up of MM and response to treatment. 6/5/2020
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- 56. • PET /CTis an old modality with an everyday rediscovering benefits . • It needs highly specialized experts to correctly interpret and a continuous research. 6/5/2020
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