Oncologic and cardiologic PET, CT diagnosis an interdisciplinary atlas and manual ; with DVD-ROM ; with 24 tables

Since 1999/2000 simultaneous imaging of anatomical features and metabolic activities using fused PET and CT images has complemented and in many cases even replaced what was originally done as separate analysis. – Is this a small revolution? – In fact, this new approach can be considered to be without a rival for imaging diagnosis. The complementary efforts of nuclear medicine physicians and radiologists have improved the diagnostic value of PET/CT scans. The successful use of PET/CT in the field of oncology has been documented world-wide, and in cardiology we can take advantage of the significant findings of PET diagnosis, particularly in the USA. New prospects are now available for paediatric oncology and molecular medicine.Based on the experience gained by PET/CT experts with more than 10,000 patients, this manual impressively demonstrates the advantages of combined PET/CT. It also refers to publications from Europe, the USA and Asia as well as numerous studies. 3540740902 Contents 1. Introduction – Positron Emission Tomography: Past and Present 1.1 Survey Physical and Biochemical Fundamentals PET in National and International Medical Care Systems 1.2 Technological Variants and Developments Coincidence PET vs. Dedicated PET Differentiated PET Evaluation Radiotherapeutic Tools PET/CT – a New Key Technology Influence of PET/CT on PET Studies Dealing with the Cost Efficiency of PET Alone PET/CT or Comparison of Co-Registered Findings? "Standard" (CARE)-CT and PET/CT PET/MRI? American Joint Committee on Cancer PET Screening in Japan and Taiwan 1.3 Increased FDG Uptake Due to Physiological and Technical Factors 1.4 References 2. Fundamentals 2.1 Preface Positron Emission Tomography (PET) Radioisotopes and PET Tracers Coincidence Measurement and Quantification PET Measurement Results and Reconstruction PET Scanners and Scintillation Detectors 2.2 Combined PET/CT Retrospective Image Fusion The PET/CT Prototype CT-Based Attenuation Correction Commercialization of PET/CT New Technical Developments in PET/CT PET/CT Acquisition Protocols Sources of Errors and Optimization Options Radiation Protection Aspects 2.3 Conclusion 2.4 References 3. Pneumology 3.1 Bronchial Carcinoma (BC) 3.2 Significance of FDG-PET in Diagnostic and Therapeutic Management Critical Evaluation of Diagnosis Management 3.3 Guidelines for [sup(18)]F-FDG-PET Indications 3.4 Technical and Biochemical Factors Is Coincidence PET Equivalent to Full-Ring PET? PET as Metabolism and Proliferation Marker Innovative Radiopharmacy 3.5 Special PET Indications False-Negative PET False-Positive PET How Useful Is Integrated PET/CT? 3.6 SCLC (Small-Cell Lung Cancer) 3.7 Pleural Processes Malignant Pleural Tumours (Mesothelioma) Imaging Methods 3.8 Case Studies Patient 1: Scar Carcinoma of the Lung Patient 2: Pneumonia Patient 3: Lymph Node Metastases of a Squamous Cell Carcinoma Patient 4: Metastasized Bronchial Carcinoma Patient 5: Round Focus in the Lung Patient 6: Metastasized Bronchial Carcinoma Patient 7: Metastasized Adenocarcinoma in the Left Lower Lobe of the Lung Patient 8: Downstaging of a Squamous Cell Carcinoma of the Lung Patient 9: Preoperative Staging of a Bronchial Carcinoma Patient 10: Pleural Carcinosis after Pneumectomy Patient 11: Recurrence of a Brain Metastasis Patient 12: Pleural Mesothelioma Patient 13: Prevention of Non-Curative Thoracic Surgery Patient 14: Upstaging of a Bronchial Carcinoma Patient 15: Bilateral Metastases of an NSCLC in the Suprarenal Glands 3.9 References 4. Gastroenterology 4.1 Introduction Molecular Strategy Metabolic Influencing Factors PET Screening? Incidentally Detected Lesions (IDL) 4.2 Oesophageal Carcinoma PET in Diagnosis Management of Oesophageal Carcinoma 4.3 Gastric Carcinoma MALT Lymphomas 4.4 Colorectal Carcinomas Treatment Status of PET PET/CT as the Optimum PET Indications Limitations of PET Artefacts FDG-PET Alternative and Adjuvant Markers Synopsis 4.5 Liver and Biliary Tract Carcinomas 4.6 Gastrointestina Stromal Tumours 4.7 Pancreas Carcinomas Imaging Curative Treatment New Gene-Based Treatment Strategies Indications DGN Classes, Consequences Impact of SUVs on Survival Time False-Negative/-Positive PET Findings Pancreas NETs (Neuroendocrine Tumours) 4.8 Neuroendocrine Tumours (NETs) of the Gastrointestinal Tract Carcinoids Conventional Diagnostics NET Spectrum Biochemistry High Secretors Low (Non-)Secretors Limitations of PET 4.9 Case Studies Patient 1: Oesophageal Carcinoma Patient 2: Lymph Node Metastasis of an Oesophageal Carcinoma Patient 3: Downstaging of an Oesophageal Carcinoma Patient 4: Carcinoma of the Head of the Pancreas Patient 5: Metastasized Carcinoma of the Head of the Pancreas Patient 6: Carcinoma of the Body of the Pancreas Patient 7: Hepatocellular Carcinoma with Multiple Metastases Patient 8: Gastric Carcinoma Patient 9: Leiomyoma of the Stomach Patient 10: Follow-Up of an Adenocarcinoma of the Stomach Patient 11: Staging of an Adenocarcinoma of the Stomach Patient 12: Staging of a Carcinoma of the Corpus of the Stomach Patient 13: Lymph Node Metastasis from Gastric Carcinoma Patient 14: Extended Metastatic Spread to the Liver from Adenocarcinoma of the Stomach Patient 15: Caecum Carcinoma Patient 16: Carcinoma of the Colon Ascendens Patient 17: T1 Carcinoma of the Colon Patient 18: Adenocarcinoma of the Sigmoid Colon Patient 19: Liver Metastasis of a Colon Carcinoma Patient 20: Lymphoma Conglomerate Following Colon Carcinoma Patient 21: Lung Metastasis Following Colon Carcinoma Patient 22: Pulmonary, Hepatic and Lymphogenic Metastatic Spread Following Sigmoid Carcinoma Patient 23: Metastasized Sigmoid Carcinoma Patient 24: Peritoneal Carcinosis and Ascites Following Sigmoid Carcinoma Patient 25: Lung Metastasis Following Sigmoid Carcinoma Patient 26: Liver Metastasis Following Sigmoid Carcinoma Patient 27: Lymph Node Metastasis Following Sigmoid Carcinoma Patient 28: Metastatic Spread to the Liver Following Rectal Carcinoma Patient 29: Liver and Lung Metastases Following Rectal Carcinoma Patient 30: Rectal Carcinoma with Lymph Node Metastases Patient 31: Suprarenal and Lung Metastases Following Rectal Carcinoma Patient 32: Lung and Bone Metastases Following Rectal Carcinoma Patient 33: Suprarenal Metastasis of a Rectal Carcinoma Patient 34: Restaging of a Rectal Carcinoma Patient 35: Suprarenal and Lung Metastases Associated with Rectal Carcinoma Patient 36: Restaging of a Rectal Carcinoma Patient 37: Local Recurrence and Liver Metastases of a Rectal Carcinoma Patient 38: Extended Metastatic Spread of a Mesenterial Conglomerate Tumour Patient 39: GIST Tumour with Liver Involvement Patient 40: Malignoma in the Left Epigastric Region Patient 41: GIST, Metastasis at the Greater Curvature of the Stomach Patient 42: Tumour Recurrence with Status Post GIST of the Stomach Patient 43: Therapy Response Follow-Up Examination Post GIST Resection Patient 44: Therapy Follow-Up in the Case of GIST 4.10 References 5. Gynaecology 5.1 Introduction The Importance of Nuclear Medical Methods 5.2 Breast Cancers Mammography Tumour Markers CT and MRI [sup(18)]F-Fluoride SPECT Sentinel Node Scintigraphy (SNS) Positron Emission Tomography Preoperative Axillary Staging Extra-Axillary Metastases Treatment Monitoring Potentials and Limitations of PET Special Neuro-Oncological Problems/Pitfalls PET Screening? Risk Stratification PET/CT Assessment of the Bone Status [sup(18)]F-Fluoride PET Diagnostic Imaging of the Breast: Indications 5.3 Ovarian Cancer Tumour Types Conventional Diagnostics PET 5.4 Peritoneal Cancer (PC) 5.5 Cervical Cancer PET Diagnostics 5.6 Case Studies Patient 1: Lymph Node Metastasis with Status Post Carcinoma of the Right Breast and Ovarian Carcinoma on Both Sides Patient 2: Inflammatory Breast Cancer Patient 3: Breast Cancer with Osseous Metastases Patient 4: Preoperative Staging of a Breast Cancer Patient 5: Restaging of a Breast Cancer Patient 6: Restaging of a Breast Cancer Patient 7: Confirmation of the Diagnosis "Breast Cancer" Patient 8: Psammoma Patient 9: Ovarian Cancer Patient 10: Restaging of an Ovarian Cancer Patient 11: Therapy Response of a Metastasized Ovarian Cancer Patient 12: Metastasized Cervical Cancer Patient 13: Bone Metastasis of a Corpus Uteri Cancer Patient 14: Trophoblastic Tumour Patient 15: Malignant Ovarian Cyst Patient 16: Peritoneal Carcinosis Due to Ovarian Cancer Patient 17: Metastasized Endometrial Carcinoma Patient 18: Exclusion of Metastatic Spread of an Endometrial Carcinoma Patient 19: Therapy Control in Case of Ovarian Carcinoma Patient 20: Lymph Node and Bone Metastases in Case of Ovarian Carcinoma Patient 21: Local Recurrence of Breast Cancer Patient 22: Restaging of a Breast Cancer after Chemotherapy Patient 23: Restaging of a Breast Cancer after Rise in Tumour Marker Level Patient 24: Primary Staging of a Breast Cancer Patient 25: Restaging of a Breast Cancer after Reduction in Tumour Marker Level Patient 26: Pre-Therapeutic Staging of a Breast Cance Patient 27: Restaging of a Metastasized Breast Cancer Patient 28: Detection of Metastases by PET/CT with Negative Conventional Imaging Patient 29: Therapy Control of a Metastasized Breast Cancer Patient 30: Therapy Control of a Metastasized Breast Cancer Patient 31: Evaluation of Radiotherapy Response in Case of Metastasized Breast Cancer Patient 32: Restaging of a Breast Cancer Patient 33: Restaging of a Breast Cancer Revealing a Fracture Risk in the C6 Vertebral Body Patient 34: Restaging of a Breast Cancer with PET/CT Providing Much More Detailed Information Patient 35: Pleural Carcinosis in a Patient with Breast Cancer Patient 36: Lung Metastases of a Breast Cancer Patient 37: Bone Metastases of a Breast Cancer Patient 38: Male Patient with Metastasized Breast Cancer 5.7 References 6. Urology 6.1 Introduction 6.2 Renal Malignancies Introduction Diagnostics 6.3 Adrenal Tumours Imaging Diagnostics 6.4 Bladder Carcinoma Status of PET 6.5 Prostate Carcinoma Introduction Diagnostics Treatment Status of Individual Imaging Methods 6.6 Germ Cell Tumours Introduction PET Study Situation 6.7 Penis Carcinoma 6.8 Case Studies Patient 1: Malignoma of the Base of the Bladder Patient 2: Malignoma of the Posterior Wall of the Bladder Patient 3: Metastasis in the Suprarenal Gland on the Left Side Patient 4: Metastasis in the Suprarenal Gland on the Right Side Patient 5: Metastasized Renal Cell Carcinoma Patient 6: Restaging after Chemotherapy Patient 7: Restaging after Tumour Nephrectomy Patient 8: Recurrence after Tumour Nephrectomy Patient 9: Metastasized Prostate Carcinoma Patient 10: Metastasized Prostate Carcinoma Patient 11: Restaging of a Prostate Carcinoma Patient 12: Lymph Node Metastasis of a Prostate Carcinoma Patient 13: First Diagnosis of a Prostate Carcinoma Patient 14: Restaging of a Prostate Carcinoma Patient 15: Restaging of a Prostate Carcinoma Patient 16: Therapy Control for Metastatized Prostate Carcinoma Patient 17: Staging of a Prostate Carcinoma Patient 18: Local Recurrence of a Prostate Carcinoma Patient 19: Lymph Node Metastasis of a Prostate Carcinoma Patient 20: Lymph Node Metastases of a Prostate Carcinoma Patient 21: First Diagnosis of a Prostate Carcinoma Patient 22: Prostatitis Patient 23: Prostatitis Patient 24: Prostatitis Patient 25: Restaging of a Prostate Carcinoma Patient 26: First Diagnosis of a Prostate Carcinoma Patient 27: Response Evaluation of a Prostate Carcinoma 6.9 References 7. Head and Neck Region 7.1 Head and Neck Tumours [sup(18)]F-FDG-PET FDG-PET Pitfalls PET Indications 7.2 Thyroid Carcinomas [sup(18)]F-FDG-PET 7.3 Case Studies Patient 1: CUP Tumour Patient 2: Tumour Recurrence of an Atypical Laryngeal Carcinoid Patient 3: Restaging of an Oropharyngeal Carcinoma Patient 4: Hypopharyngeal Carcinoma Patient 5: Restaging after Multiple Carcinoma Patient 6: Auricle Carcinoma Patient 7: Tonsillar and Laryngeal Carcinoma and Carcinoma of the Base of the Tongue Patient 8: Recurrence of a Squamous Cell Carcinoma of the Tongue Patient 9: Tonsillar Carcinoma Patient 10: Restaging of a Small-Cell Carcinoma of the Left Principal Nasal Cavity Patient 11: Recurrence of a Vocal Cord Carcinoma Patient 12: Cerebral Metastatic Spread of a Bronchial Carcinoma Patient 13: Cystadenocarcinoma of the Lacrimal Sac Patient 14: Alzheimer's Disease Patient 15: Oligodendroglioma on the Left Side Patient 16: Low-Malignancy Brain Tumour on the Left Side Patient 17: Hypophyseal Metastasis 7.4 References 8. Dermatology 8.1 Malignant Melanoma (MM) Introduction Significance of PET Pitfalls PET Indications 8.2 Case Studies Patient 1: Malignant Melanoma of the Right Thigh Patient 2: Recurrent Melanoma Patient 3: Metastasized Melanoma Patient 4: Choroidal Melanoma Patient 5: Metastasized Amelanotic Melanoma 8.3 References 9. Lymphomas 9.1 Introduction 9.2 Diagnosis Imaging Methods FDG-PET Response Evaluation Comparison of FDG-PET, [sup(67)]Ga and CT Autologous Stem Cell Therapy PET/CT Restaging Artefacts Other Problems PET Indications 9.3 Case Studies Patient 1: Follicular Non-Hodgkin's Lymphoma Patient 2: Metastasized Non-Hodgkin's Lymphoma Patient 3: B-Cell Lymphoma in the Hypopharynx Patient 4: B-Cell Lymphoma Patient 5: Lymphogranulomatosis, Nodular Sclerosis Patient 6: T-Cell Lymphoma of the Cervical Lymph Tract Patient 7: B-Cell Lymphoma Patient 8: Restaging of Hodgkin's Disease Patient 9: Recurrent Hodgkin's Lymphomas Patient 10: Chronic Lymphatic Leukaemia Patient 11: Restaging of the Multiple Myeloma 9.4 References 10. Oncological Orthopaedics 10.1 Introduction 10.2 Significance of PET PET Tracers PET Indications 10.3 Case Studies Patient 1: Sweat Gland Carcinoma Patient 2: Haemangioendothelioma Patient 3: Chondrosarcoma Patient 4: Medullary Osteosarcoma Patient 5: Clear Cell Sarcoma Patient 6: Rhabdomyosarcoma Patient 7: Rhabdomyosarcoma of the Left Thigh Patient 8: Embryonal Rhabdomyosarcoma 10.4 References 11. Paediatric Oncology 11.1 Introduction Changes in the Range of Clinical Indications 11.2 Lymphomas in Childhood Staging, Restaging, Prognosis and Therapy Control 11.3 Oncological Orthopaedics in Childhood 11.4 Neuroblastomas 11.5 Malignant Melanomas 11.6 Nesidioblastosis (Congenital Hyperinsulinism) 11.7 Case Studies Patient 1: Status Post Osteogenous Sarcoma Patient 2: Status Post Mastitis Patient 3: Embryonal Rhabdomyosarcoma Patient 4: Focal Congenital Hyperinsulinism Patient 5: Focal Congenital Hyperinsulinism Patient 6: Focal Congenital Hyperinsulinism Patient 7: Diffuse Congenital Hyperinsulinism Patient 8: Focal Congenital Hyperinsulinism Patient 9: Focal Congenital Hyperinsulinism Patient 10: Focal Congenital Hyperinsulinism Patient 11: Langerhans Cell Histiocytosis Patient 12: Langerhans Cell Histiocytosis, Staging and Restaging 11.8 References 12. CUP Tumours 12.1 Introduction 12.2 Significance of PET Cancer of Unknown Primary: Indication for PET/CT? Studies Available Artefacts, Pitfalls and Metabolic Heterogeneity 12.3 Case Studies Patient 1: Carcinoma of the Base of the Tongue Patient 2: Carcinoma of the Base of the Tongue Patient 3: Oropharyngeal Carcinoma Patient 4: Cholangiocarcinoma Patient 5: Pancreatic Carcinoma Patient 6: Carcinoma of the Head of the Pancreas Patient 7: Mamma Carcinoma Patient 8: CUP Tumour Patient 9: Mamma Carcinoma Patient 10: Carcinoma of the Base of the Tongue Patient 11: Bronchial Carcinoma Patient 12: Bronchial Carcinoma 12.4 References 13. Pitfalls 13.1 Testicular Carcinoma and Other Primary Tumours Universal Organ Spectrum of SPT 13.2 Physiological Accumulation of FDG 13.3 False Positive FDG Accumulations in the Oncological Sense 13.4 Artefacts Due to Technical Factors 13.5 False Negative PET Findings 13.6 Case Studies Secondary Tumours Patient 1: Inflammatory Carcinoma of the Breast and Papillary Carcinoma of the Inner Genital Tract Patient 2: Carcinoma in Situ with Osteoplastic Metastases 10 years later Patient 3: Recurrence of a Sigmoid Carcinoma, Compression of the Left Ureter Patient 4: Cervical Carcinoma and Rectal Carcinoma Patient 5: Mamma Carcinoma and Colon Carcinoma Patient 6: Mamma Carcinoma and Sigmoid Carcinoma Patient 7: Thymoma Patient 8: Prostate Carcinoma and Colon Carcinoma Patient 9: Renal Cell and Prostate Carcinoma Patient 10: Prostate Carcinoma and Colon Carcinoma Patient 11: Carcinoma in Situ of the Rectum and Bronchial Carcinoma Patient 12: Non-Hodgkin's Lymphoma and Bronchial Carcinoma Patient 13: Mamma Carcinoma and Bronchial Carcinoma Patient 14: Coecum, Bronchial and Renal Carcinoma Patient 15: Mamma, Cervical and Rectal Carcinoma Patient 16: Parotid and Colon Carcinoma 13.7 Case Studies Physiologically Increased Uptake Patient 17–21 13.8 Case Studies Non-Oncological Increased Uptake of Inflammatory Genesis Patient 22–31 13.9 Case Studies Artefacts Patient 32–39 13.10 References 14. Radiotherapeutic Aspects 14.1 Introduction 14.2 PET-Assisted Radiotherapy Planning 14.3 Advantages of PET/CT Integration 14.4 Fundamentals Governing the Use of PET/CT Data for Radiotherapy – Bits and Bytes and DICOM 14.5 Case Studies Patient 1: Prostate Cancer Patient 2: Oropharyngeal Cancer Patient 3: Breast Cancer Patient 4: Prostate Cancer Patient 5: Squamous Cell Carcinoma of the Oral Cavity Patient 6: Bronchial Cancer 14.6 References 15. Nuclear Cardiology 15.1 Introduction Development of Nuclear Cardiology and the Present State Molecular Cardiac Imaging Fusion Imaging SPECT and SPECT/CT MRI and PET/MRI 15.2 Cardiac PET/CT Coronary Sclerosis Diabetes Mellitus and Coronary Sclerosis Plaque Imaging Perfusion Vitality Radiation Exposure and Contrast Medium Safety Artefacts Invasive Diagnostics, Treatment and Treatment Monitoring Prevention Remarks on the Catalogue for Further Training for the Specialization in Nuclear Medicine 15.3 Case Studies Patient 1: Mild CHD Patient 2: Status Post Revascularization Patient 3: Status Post Anterior Infarction and Sextuple Bypass Patient 4: Surprise Finding of Stem Stenosis 15.4 Reference 16. Cardiac PET and PET/CT 16.1 Introduction 16.2 Coronary Artery Disease Imaging with PET Accuracy of PET and PET/CT Stress-Rest Myocardial Perfusion Imaging Advantages of Myocardial Perfusion Imaging with PET Hybrid PET/CT Myocardial Perfusion Imaging in Coronary Artery Disease 16.3 Myocardial Viability Concepts and Pathophysiology Assessment of Myocardial Viability Imaging of Myocardial Perfusion and Metabolism Clinical Implications of Perfusion Metabolism Imaging PET/CT vs. Stand-Alone PET Clinical Indications of Perfusion Metabolism Imaging 16.4 Vascular Inflammation and Atherosclerosis 16.4.1 Large Vessel Vasculitis 16.4.2 Atherosclerosis and Plaque Imaging 16.5 Future Developments 16.6 References 17. Future Trends: Molecular PET 17.1 Technical Potential and Software Optimization 17.2 Molecular PET Tumour Vitality and Glucose Transporters (GLUT) Therapeutic and Diagnostic Potential 17.3 Final Remark 17.4 References Subject Index A B C D E F G H I K L M N O P Q R S T U V W X Z Accompanying Dvd-rom Contains ... A Comprehensive Overview Of Additional Literature, The Entire Text In Electronic Form And Several Case Studies Which - When Examined With The Viewer - Give An Impression Of The Three Dimensional Nature Of The Studies.--p. [v]. Wolfgang Mohnike, Gustav Hör, Heinrich R. Schelbert (eds.) ; With Contributions By Thomas Beyer, Konrad Mohnike, Stefan Käpplinger. Dvd-rom In Pocket. Includes Bibliographical References And Index. System Requirements: Dvd-rom Drive. Based on the experience gained by PET/CT experts with more than 10,000 patients, this manual impressively demonstrates the advantages of combined PET/CT. It also refers to publications from Europe, the USA and Asia as well as numerous studies. The comprehensive literature list at the end of each chapter is extended on the DVD which accompanies the book. This list goes beyond the field of PET/CT and takes into account neighbouring disciplines