In oncology, PET permits a physician to accurately image many
organs of the body with a single scan in order to detect
malignancy. PET has demonstrated usefulness in cost-effective
whole-body metastatic surveys, avoiding biopsies. The
benefits of PET include non-invasive differentiation of tumors
from radiation necrosis, the possibility to change the course
of ineffective chemotherapy and avoidance of unnecessary
diagnostic and therapeutic procedures. Applications for PET
in oncology include:
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Brain Tumor
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Differentiate a recurrent tumor from radiation
necrosis.
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Differentiate primary CNS lymphoma from toxoplasmosis.
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Exclude brain metastatic disease.
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Breast Cancer
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Identify involved axillary nodes or distant metastatic disease.
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Exclude local recurrence of disease.
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Evaluate response to treatment.
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Colorectal Cancer
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Detect locally recurrent or distant metastatic disease in patients with elevated or rising CEA who may be candidates for surgical re-excision.
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Rule out distant metastases for preoperative evaluation.
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Head & Neck Cancer
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Determine extent of local, regional and distant disease.
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Detect recurrent/residual tumor following
definitive therapy.
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Lung Cancer
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Distinguish malignant pulmonary nodules from benign ones.
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Stage mediastinal or distant metastatic disease.
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Use as part of radiotherapy treatment planning.
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Detect recurrent/residual tumor following definitive therapy.
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Lymphoma
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Determine extent of disease and measure treatment response.
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Melanoma
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Identify extent of local and regional disease spread in patients with high risk melanoma (e.g., primary tumor less than 4mm) or in suspected recurrence.
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Musculoskeletal Tumors
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Evaluate local extent of disease and exclude distant metastases.
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Measure treatment response and exclude recurrent/residual tumor following definitive therapy.
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Ovarian Cancer
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Detect recurrent/residual tumor prior to surgical exploration or additional chemotherapy.
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Pancreatic Cancer
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Differentiation of benign processes such as pancreatitis, mucinous cyst adenoma and pseudocyst from malignant disease.
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Rule out distant metastases during preoperative evaluation.
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Thyroid Cancer
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Detect metastatic or locally recurrent disease
in patient with elevated thyroglobulin after
definitive initial treatment and negative
I-131 examination.
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References
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Conti, P.S., Lilien, D.L., Howley, K.,
Keppler, J., Grafton, S.T., Bading, J., PET
and F-18 FDG in Oncology: A Clinical
Update. Nuclear Medicine and Biology,(1996)
23:717-735. Di Chiro, G., Positron Emission
Tomography Using FDG in Brain Tumors: A
Powerful Diagnostic and Prognostic
Tool. Investigational Radiology, (1986)
2:360-371.
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