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HYBRID IMAGING. HYBRID IMAGING. Combination Nuclear medicine Radiology PET/CT Positron emission tomography Computed tomography SPECT/CT Single photon emission tomography Computed tomography PET/MRI. Beta plus decay. Nucleus reach of protons Proton is transformed to neutron
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HYBRID IMAGING • Combination • Nuclearmedicine • Radiology • PET/CT • Positron emissiontomography • Computedtomography • SPECT/CT • Single photonemissiontomography • Computedtomography • PET/MRI
Beta plus decay Nucleusreachofprotons Proton istransformed to neutron Emissionof positron and neutrino Periodical table shift to theleft by onesite 18F to18O Positron islivingonlyfewms Annihilationofthematter Interactionofelectronand positron Gammarays 2 quanta E – 511 keV Uniqueenergy Angle180o n g 18F 511 keV e+ 180 e- g 511 keV
Radiopharmaceuticals • 18F halftime110 min • 18FDG – fluorodeoxyglucose • 18FLT – fluorothymidine • Na18F • 18F-Estradiol, 18F-methionin, 18F-DOPA, 18F-cholin • 68Ga halftime 68 min • DOTA derivates • somatostatineanaloga • 11C halftime 20 min • 11C-acetate, 11C-cholin • 13N (9 min), 15O (123 s), 82Rb (78 s)
Imagingtechnique Applicationof radiofarmaka Oral preparation 1000 ml 2,5% manitol CT data acquisition PET data acquisition 7 positions per 3 min
Oral preparation 2,5% mannitol
Postprocessingfusion CT + PET Multiple colorectalcancer
18F-fluorodeoxyglucose plasma cell glucose glucose glucose-6-P glycolysis 18F-FDG 18F-FDG 18F-FDG-6-P transport phosphorylation glycolysis
18FDG-PET/CT • Increaseduptake • Tumoroustissueswithincreasedglycolyticactivity • Inflammatoryreaction • Physiologicaluptake • brain • Brown fattytissue • Strippedmuscles • Kidneys • Sallivaryglands
staging Bronchogeniccarcinoma Headandnecktumours Lymfoma Melanoblastoma
Therapystrategy SarcomatendinisAchill. Leiomyosarkoma Synovialsarcoma
Restaging Therapy response effect Definitive In themiddlebetweencycles
Oropharyngealcancer 18 months after
Earlyaftersurgery 3 monthslater
Cervicalcancer myom myom Ca Ca Beforeth Afterth
Grading theassesmentofthebiologicactivity More dedifferenciated – higher FDG uptake
Feverofunknownorigin M. Hodgkin
18F-fluorothymidine replication DNA = cellularproliferation Fastdividingcells Tumors Bone marrow Germinativezonesoflymphnodes Therapy monitoring – RT, CHT
18F-natriumfluoride Bone turnover fluoroapatite Osteoblasticactivity Osteoplastic bone metastases Ca prostate Ca breast Ca lungs Bony tumors