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PET/CT

Introduction

The use of PET/CT has been growing exponentially, and in all regions of the world. This great success is based on the ability of the equipment to combine anatomical and functional information in one patient examination, which optimizes the clinical utility of the images. The success is also based on the introduction of FDG labeled with F-18, a radionuclide with a half-life long enough to allow for transportation between the site of production and the user. The clinical application of FDG includes cardiology and neurology but mainly oncology where it is used for diagnosing, staging and re-stating of cancer, as well as in the planning and monitoring of cancer treatment.

Important principles

Establishment of a successful PET/CT practice requires integration of the two techniques on several levels, including planning and design of the PET/CT facility, staffing (categories, number, training), supply of radiopharmaceuticals, patient preparation and management procedures, imaging protocols, radiation protection and quality assurance. It is important that a medical physicist actively take part in the planning of the facility as well as in the routine work such as the quality control programme.

Introduction to references

The IAEA has recently published a document entitled Quality Assurance for PET and PET/CT Systems, which outlines QC procedures for PET/CT provides guidance about the specifications and prerequisites required for acceptance testing of PET and PET/CT scanners, including the professionals to be involved, definitions of applications, minimal required configurations and corresponding performance parameters, as well as ancillary equipment. The PET acceptance tests described in this publication adhere closely to the NEMA 2007 standard. It also provides guidelines for routine QC of PET and PET/CT scanners, as well as a framework for setting reference values, tolerance values and action levels.

The establishment of a PET/CT facility is discussed in the article by Shreve. More extended information is found in the IAEA-document Planning a Clinical PET Centre. The basic physics and technology of PET/CT is provided in the article by Townsend and the IAEA publication on Quality Assurance for PET and PET/CT Systems, as well as in a powerpoint-presentation on the IAEA Radiation Protection of the Patient website, which also covers radiation protection matters. Structural shielding of a PET/CT facility is discussed in the document from AAPM Task Group 108.