PET/CT imaging

Clinical case - Improvement in staging accuracy

   
 
     
  Who we are  
 
 
  Doctor Renée Ahond-Vionnet
Senior Clinical lecturer in Nuclear Medicine Department


Centre Hospitalier De Nevers, Nuclear Medicine Department
Nevers, France


The nuclear medicine department of CH NEVERS, France, led by Dr Ahond-Vionnet, has 2 Gamma-Camera systems (one double-head Millenium MG and one hybrid Infinia Hawkeye4).

 
 

Since April 2008, the department is equipped with a GE PET/CT Discovery RX with Motion Free and PET VCAR applications.

This PET/CT system helps clinicians to improve diagnostics and therapy follow-up of patients with cancerous lesions.

Thanks to Motion Free, we help radiotherapy physicists and physicians to define more accurately the irradiation dose and volume for RT planning.

 
  T E P Bourgogne Loire  
     
  Patient History  
 
 
 

Male - 67 years old - 182cm - 78kg

 
 

Excision of adenopathies 6 months ago. The PET acquisition pointed out numerous adenopathies with a pulmonary suspicion.

Last CT exam from May 2007 revealed the 2 left cervical adenopathies with two round right nodules intra-parenchymatous in the middle lobe.

No chemotherapy or radiotherapy for the past 6 months.

 
     
  Acquisition  
 
 
 

Scanner: GE Discovery RX

 
     
  PET acquisition: Whole-body then dedicated Head & Neck acquisition  
 
3D acquisition
Whole-body PET – 1 min30 /bed - VUE Point reconstruction
Head & Neck acquisition: one bed position - VUE Point HD reconstruction
Post-injection time: 1h
Dose: 274 MBq of 18F-FDG
 
     
  CT acquisition: Head & Neck acquisition  
 
Detector configuration: 16 x 1.25 mm
Slice thickness : 1.25mm
kVp : 120 ; mA : 80
 
     
     
  Findings  
 
 
 
Fused coronal views of the jugular – carotid chains  
       
No uptake separation using VUE Point
 
Small anterior uptake seen using VUE Point HD  
No uptake separation using VUE Point   Small anterior uptake seen using VUE Point HD  
       
Fused axial view – VUE Point HD      
Fused axial view – VUE Point HD      
       
 
 

Neck: individualization of five high jugular-carotid chains uptakes located in the area III and IV. The lowest and inferior uptake shows the existence of a very small anterior uptake.

 
 

Thorax: high anterior-mediastinal uptake

 
 

Lungs: No uptake in the two nodules described on the diagnostic CT

 
     
     
  Conclusion  
 
 
 

Confirmation of high uptakes on the left jugular-carotids chains on the areas III and IV. Using VUE Point HD provides more accurate diagnosis improving the clinician’s staging confidence.

No abnormal uptakes of 18F-FDG on the lungs area.

 
 
 
   
   
   
   
   
   
     
Who we are  
Patient History  
Acquisition  
Findings  
Conclusion