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PET/CT Modality Combination

PET/CT Modality Combination. Clinical LOINC – Diagnostic Imaging PSWilson , February 14, 2013. Positron Emission Tomography.

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PET/CT Modality Combination

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  1. PET/CT Modality Combination Clinical LOINC – Diagnostic Imaging PSWilson, February 14, 2013

  2. Positron Emission Tomography • “Is a technique that measures physiological function by looking at blood flow, metabolism, neurotransmitters, and radiolabelled drugs. PET offers quantitative analyses, allowing relative changes over time to be monitored as a disease process evolves or in response to a specific stimulus.​” • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1126321/

  3. Applications of PET • Cardiology • Oncology • Neurology

  4. Use of PET for Oncology • Metabolism and Physiology • Staging or Restaging of Cancer (not initial dx) • Prior to Chemo, Radiation Tx, or Surgery • Always full body • Always injection of FDG

  5. Computerized Tomography • Majority of imaging is Head/Torso or full body • Used as a complement to PET • May or may not have IV or Oral Contrast

  6. PET with CT • PET for physiology, CT for anatomy • 2 settings, different times, thus 2 reports • Problem with overlay due to repositioning • Current is a single unit • Same setting, same position • Single report

  7. Protocols for PET • Head and Thorax • Head/Neck Cancer • Whole Body • Breast • Melanoma • Sarcoma • Mid Skull to Thigh • Everything else

  8. Protocol for CT • With IV Contrast • Gastrointestinal (also Oral and/or Rectal) • Neuro • Endocrine • Without Contrast • Thyroid • Renal • Breast • With and Without IV Contrast • Lung

  9. LOINC Perspective • Observation is the same whether or not the images were obtained from a single or different machines • Rarely dictated as a separate report • Diagnosis is not pertinent (captured elsewhere in HL7 • Staging versus Re-staging (same protocol) • Separate CT report for any additional images for diagnostic purpose

  10. Proposed (Breast,Thyroid, Renal)

  11. References • http://www.ccsnm.org/pdfs/2010/protocols/PET-CT%20FDG%20Guidelines.pdf • http://bjr.birjournals.org/content/80/954/437.full • http://radiology.rsna.org/content/244/1/263.full • http://radiographics.rsna.org/content/27/suppl_1/S215.full • http://jnm.snmjournals.org/content/45/1_suppl/25S.full

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