Andrei Iagăru
Division of Nuclear Medicine, Stanford University Medical Center
Abstract
Positron Emission Tomography (PET) has gained widespread acceptance for the diagnosis, staging, and management of a varie ty of malignancies. The fundamental strength of PET over conventional imaging is the ability to convey functional information that even the most exquisitely detailed anatomic image cannot provide. 18 F FOG, the standard PET radiophar maceutical in clinical use curren tly, is a glucose analog that is taken up by cells in proportion to their rate of glucose metabolism. The increased glycolytic rate and glucose avidity of malignant cells in comparison to nor mal tissue is the basis of the ability of 18 F FOG PET imaging to accurately differentiate cancer from benign tissue regardless of morphology (80). Dual modality PET/CT increases patient convenience by permitting PET and CT imaging in a single appointment. But perhaps more importantly, initial studies indicate that the sum of the two modalities is better than either used separately. Despite the high costs associated with PET/CT scanning, significant savings are possible for the healthcare system due to avoidance of unnecessary surgeries (through accurate staging), selection of the ap propriate therapy and early detection of cancer recur rence.