PET/CT imaging

Clinical case - Improvement in the localization accuracy

   
 
     
  Who we are  
 
 
  Doctor Catherine Tainturien, MD
Head of Nuclear Medicine Department

Doctor Elise Le Stanc, MD
Nuclear Medicine Physician

Hôpital Foch,
Suresnes, France

We are a Nuclear Medicine Department in a general hospital close to Paris (France).

Our facilities comprise one gamma-camera, one SPECT/CT and one PET/CT.

Our hospital is a multidisciplinary one, with high surgical and oncological activities.

We mainly perform 18F-FDG PET/CT scans for patients presenting with lymphoma, head and neck, lung and digestive carcinomas.

  
  Hopital Foch  
     
     
  Patient History  
 
 
 

Male - 75 years old - 165cm - 70kg

  
 

Rectosigmoid colon adenocarcinoma in 2005, pelvic recurrence in 2007, both treated surgically.

In 2008 , a new hepatic nodule found on CT and increased CEA.

Patient referred to 18F-FDG-PET/CT for recurrence staging.

 
 

 

  
     
  Acquisition  
 
 
 

Scanner: GE Discovery STE

  
     
  PET acquisition: Whole-body static and MotionFree acquisition  
 
– 3D acquisition using VUE Point HD reconstruction
– Acquisition time:
 
  • Whole-body acquisition: 3 min/bed
    		•
     
  • MotionFree acquisition: 6 bins - 2 min/bin
    		•
    – Post-injection time: 1h50 min
    – Dose: 288 MBq of 18F-FDG
    		 
         
      CT acquisition:  
     
    – Static CT Attenuation Correction whole-body acquisition
    – MotionFree acquisition both for CTAC and diagnosis
       
    		 
         
      Findings  
     
    		 
     
       
    abnormal focus   abnormal focus  
    The circle points out an abnormal focus which appears localized in the right lung  
     
    liver hepatic  
    Fused MotionFree PET & CT images shows the uptake localization in the liver hepatic dome
    		 
     

    The static whole-body scan shows a colic recurrence (focal intense uptake close to the midline). A second abnormal focus is localized in the right lung base.

    The MotionFree acquisition confirms the uptake localization in the hepatic dome of the liver and not in the right lung base as it seems to be on the static whole-body scan.

    		  
         
         
      Conclusion  
     
    		 
     

    The whole-body scan localizes the lesion in the right lung base.

    		  
     

    MotionFree allows to account for tumor motion due to patient breathing, giving a clear vision of the lesion’s location at the top of the liver.

    		  
         
         
     
    		 
       
       
       
       
       
       
         
    Who we are  
    Patient History  
    Acquisition  
    Findings  
    Conclusion  
         
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