Clinical Application Positron Emissio Tomogray in Oncloy

Chung, June Key

Abstract

Positron Emission Tomography(PET) is a new imaging modality to make biochemical metabolic images. Because biochemical changes precede anatomical changes in most of diseases including cancer, PET can detect earlier changes of diseases than conventional anatomical imaging modalities. PET can also characterize biochemical property of diseases. A PET center is composed of a medical cyclotron, synthesis system of radiopharmaceuticals and scanner. For PET oncology, several positron-emitting radiopharmaceuticals have been developed. Among them, F-18-fluorodeoxyglucose (FDG) is most frequently used. Higher rate of glucose metabolism has been observed in cancer cells. Like glucose, FDG is transported into the cancer cells and converted to FDG-6-phosphate by hexokinase. FDG-6-phosphate is trapped in the cytoplasm, and emits gamma rays to make PET images. The current application of FDG PET in oncology is in detection, differentiation, and staging of the primary tumors, grading malignancy, monitoring therapeutic response, and early detection of recurrence. Nowadays, PET is an established procedure for staging the diseases and detecting the recurrence in many cancers, especially the lung, colorectal, and head and neck cancers, melanoma, and lymphoma. PET is a regular part of medical insurance reimbursement in many developed countries, and becomes a valuable research tool in oncology as well as an important imaging modality in managing cancer patients.