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XRC Medical Imaging is pleased to be the only facility in
our area to offer PET-CT Fusion Imaging. What is PET-CT Fusion
Imaging? It is the very latest imaging technology that combines
the anatomical detail of CT (Computerized Tomography) with
the molecular metabolic information derived from PET (Positron
Emission Tomography).
Almost everyone is familiar with
CT or “CAT” scans,
which have been commonplace in medicine for approximately
30 years. Today’s CT scanners are better and faster
than ever, capable of producing up to 16 “slices” of
imaging in 0.5 second. Still, they are sometimes unable to
detect tiny, often sub-clinical malignancies. Left undetected
(and therefore untreated), these malignancies will grow and
possibly metastasize, making their eventual treatment more
challenging. Even when they are detectable on CT scans, they
merely appear as abnormal masses and there is often uncertainty
with regard to whether they are malignant or benign.
More recently, PET imaging has become
a technology available in most communities. PET imaging
is a nuclear medicine procedure
in which a radioactive isotope, 18-fluorodeoxyglucose (FDG),
is injected intravenously. The glucose, or “sugar” component
of the FDG allows it to be “taken up” in cells
seeking sugar. Because cancer cells are sugar-seekers, a
disproportionate amount of FDG is captured within malignancies,
making even tiny tumors visible during the scanning process.
PET therefore, succeeds where conventional
CT fails, because it provides for the imaging of very small
tumors, and while
a diagnosis of cancer cannot be made without a biopsy, PET
can prove to be a strong indicator. Furthermore, the PET
scanner can generate SUV’s (Standard Uptake Values)
for any point of FDG uptake, which in some instances serves
as not only a further indicator of malignancy but also the
tumor’s “grade”. PET has also proven very
useful in staging cancer patients, sometimes eliminating
the need for surgery.
Unfortunately though, PET scans do
not show nearly the anatomical detail that CT scans do,
and while physicians can often identify
potential malignancies, they are sometimes unsure of their
exact location. This conundrum has led to the development
of a hybrid PET-CT combination scanner in which PET and CT
imaging are done simultaneously and “fused” together
to provide the best features of both CT and PET on a single
image. In essence, it provides the best of both the CT and
PET worlds.
In addition to providing more information,
PET-CT is actually quicker to perform than a standard PET.
Scan times are only
about 20 minutes (as compared to PET’s 45 minutes)
because the hybrid scanner utilizes both the transmission
radiation from the CT tube and the emission radiation from
the FDG. PET-CT also eliminates the need for urinary bladder
catheterization, which is uncomfortable for patients.
One would imagine that with all of
its advantages and equipment requirements, PET-CT would
be extremely costly, but these
scans are priced identically to a standard PET scan. So,
in reality, the CT scan with all of its added anatomical
information, is kind of a “freebee”. What it
really is, however, is value added data.
PET-CT is covered by most insurances and by Medicare. Medicare
is continually adding to its list of approved clinical indications
for PET and PET-CT. Currently, Medicare authorizes PET and
PET-CT for:
• Solitary pulmonary nodules
• Non-small cell lung cancer
• Colorectal cancer
• Melanoma
•
Lymphoma (Hodgkin’s and Non-Hodgkin’s)
• Head and Neck cancer
• Esophageal cancer
• Breast cancer
• Certain neurologic and cardiac indications
PET-CT is useful for more than just “finding” and
staging cancers; it can play an important role in monitoring
a tumor’s response to chemotherapy or radiation therapy.
In many instances a follow-up PET-CT scan can be performed
after the first cycle of therapy to gauge the impact that
the therapy regimen has had. If there has been a significant
reduction in the tumor’s size or SUV, it can safely
be said that the therapy has been successful and if indicated,
can be effectively continued. On the other hand, should a
follow-up PET-CT show little or no tumor response, a change
in treatment might be indicated. This, obviously, can significantly
improve treatment outcomes, shorten treatment durations and
provide substantial cost savings.
XRC Medical Imaging’s Mission Statement, in part,
is to provide “…the highest caliber of medical
imaging services…”. PET-CT fits perfectly with
that statement. It is our vision to continue to be the imaging
leaders in our community and to always be at the forefront
at bringing technologies like PET-CT into the community.
If you would like to learn more about PET-CT or would like
for an XRC Medical Imaging representative to speak about
PET-CT to a group that you belong to, please contact us at
(574) 243-0100.
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