Positron Emission Tomography and Computed Tomography (PET CT)

PET/CT combines the strengths of two well-established imaging modalities, CT for anatomy and PET for function, into a single imaging device. By imaging with the two modalities in a single scan, disease can be both identified and localized, potentially resulting in an earlier diagnosis and more accurate staging of cancers. PET/CT can also show how the disease is responding to treatment.

PET/CT scanners provide accurately aligned anatomical and functional images of a patient, allowing functional abnormalities to be localized and distinguished from normal uptake of the PET tracer, which increases physician’s confidence in arriving at the correct diagnosis.

How PET Works
Cancer cells require a great deal of sugar, or glucose, to have enough energy to grow. PET scanning utilizes a radioactive molecule that is similar to glucose, called fluorodeoxy glucose *(FDG). *FDG accumulates within malignant cells because of their high rate of glucose metabolism.

Once injected with this agent, the patient is imaged on the whole body PET scanner to reveal cancer growths which may have been overlooked or difficult to characterize by conventional CT, X-Ray, or MRI.

Breast cancer staging PET CT

How CT Works
CT is short for computed tomography. CT uses x-rays and a computer to make an image of sections of your body. A CT scan shows your body’s organs, bones and tissues in greater detail than regular x-ray do. CT exposes you to small amount of radiation.

Combined PET/CT Imaging : The Added Advantage
The PET/CT scanner at WIMC combines two state of the art imaging modalities. By monitoring *FDG uptake, PET provides very sensitive information whether a growth within the body is cancerous or not.

CT meanwhile provides detail information about the location, size and shape of various lesions but cannot differentiate cancerous lesions from normal structures with the same accuracy as PET. CT will also provide additional information on the pathology.

The combined PET/CT scanner merges PET and CT images together. The PET/CT scan at WIMC is reviewed and co-related by a Nuclear Medicine Physician and a Radiologist who writes a full report for each patient.

CT image	PET / CT image

How does PET / CT help
The three areas in which PET is making critical contributions are in:

1) Oncology - Lung cancer, breast cancer, testicular and ovarian cancer, recurrent colorectal cancer, lymphoma, melanoma, recurrent brain tumors, tumor-therapy monitoring and assessing effectiveness of treatment such as chemotherapy, - it pinpoints the disease and helps guide therapy to improve your quality of life while fighting cancer.

2) Cardiology - Myocardial viability - a form of non-invasive stress test to help determine the presence and extent of coronary artery disease.

3) Neurology - Diagnosis of Alzheimer, - the study of the blood flow and metabolic activity in the brain can identify certain neurologic and central nervous system disorders.

Frequently Asked Questions (FAQs)

• Can I have a PET/CT scan if I am allergic to contrast dyes?
  Yes
  
  
• Are there any side effects?
  You will feel no side effects from the radioactive injection.
  
  
• Can I take my medication the morning of the test?
  For diabetic patient, please consult our doctor for specific instructions and bring along your diabetic medication with you. All other medication can be taken prior to the test.
  
  
• Can I exercise the day before?
  Preferably not except for routine light exercise.
  
  
• Can I have caffeine?
  It is best to only have plain water on the day of the test.
  
  
• Can I wear body jewellery?
  Please do not wear any jewellery.
  
  
• What do I do after the test is finished?
  You may go home when the study is finished and resume your regular diet and medication. You are encouraged to drink plenty of water to help clear the radioactivity from your body and empty your bladder as often as possible.
  
  
• How do I find out about my test results?
  After the scan, the images will be processed and the report will be forwarded to your referring doctor, who will then discuss the results with you at your next follow up appointment.
  

PET/CT Procedure
Patients referred for PET/CT scanning will be required to spend approximately 3 hours at WIMC.

Patients are first injected with a very small amount of the *FDG radiotracer. The patient then waits approximately 45 - 60 minutes prior to scanning to allow for the *FDG to adequately target and bind to possible cancer cells within the body.

Most tumours have a higher metabolic rate than surrounding normal tissue. PET images of *FDG uptake can often differentiate the benign from malignant tumours, based on the intensity of *FDG uptake reflecting their metabolic rates.

Before your Appointment
You are advised not to engage in strenuous muscular exercises at least two days before the scan.

In order for your PET/CT scan to be successful, structured instructions will be provided by our PET CT staff. The necessary pre-examination instructions include:

• Fast at least 4 hours prior
  We recommend that you have nothing to eat for at least 4 hours prior to your test (except water and your usual medications).
  
  
• Drink water
  You are encouraged to drink 3 - 4 glasses of water prior to arriving at WIMC.
  
  
• Consult us or your doctor if you are diabetic
  You may take all other medications as usual.
  
  
• Confirm your appointment 24 hours prior
  You must be confirmed for your appointment 24 hours prior to the test and a deposit would need to be paid.
  

Please bring along all recent radiological films in your possession when you come for the scan.

On the Day of your Appointment

• You should plan to be at WIMC about 30 minutes before your scanning appointment.
  
  
• Kindly complete the necessary registration requirements and make payment at the customer services counter located on the Ground Floor of WIMC.
  
  
• After payment, you will be directed to the PET/CT area.
  

Before Scanning
Upon arrival at the area, please inform our Radiographer on duty:

Following the *FDG injection, you will be asked to lie quietly for 45 - 60 minutes. This is to allow the *FDG to be distributed around the body. You should refrain from walking or doing anything strenuous.

Just before scanning time, we will advise you to empty your bladder and direct you to the scanning room. You will then be imaged on the PET/CT scanner for approximately 30 - 45 minutes.

During the examination
You will be required to lie flat with your arms raised above your head. If you think you will be unable to keep your arms above your head for approximately 35 minutes, please inform the radiographer of it.

The first part of the scanning is for CT scan. The scanner bed will move in towards the scanner opening for a short time, during which you will hear some noise coming from the system. This will conclude the CT portion of the scan.

After the CT scan is completed, the PET scan will begin. The bed will move over a short distance at a time and images are acquired. There will be between 5 - 7 bed movements depending on your height and parts to be imaged. This scan will take a total of 20 - 30 minutes to complete. Our radiographer will keep you informed about what is going on.