PET/CT imaging

Clinical case - PET sensitivity reveals a 3mm metastasis

   
 
     
  Who we are  
 
 
  Diana Salvo, MD
Clinical Director and Head of Institute of Nuclear Medicine


Annibale Versari, MD
Senior Clinical lecturer in Multimodality Imaging


Federica Fioroni, MS
Medical Physicist


Archipedale Santa Maria Nuova
Reggio Emilia, Italy


The Reggio Emilia ASMN PET Center was created in 2000. In 2002, a 10 MeV Cyclotron (Minitrace GE) was installed in order to produce clinical 18F-FDG and 18F-Choline. A protocol to produce 18FLT and 18F-MISO will also be available soon for research purpose.
In 2005, the first PET system was replaced by a GE Discovery STE PET/CT system.
The center is accredited as Center of Excellence of the Italian association of Nuclear Medicine for the problems related to "PET and radiotherapy" and, on these themes, it delivers brief theoretical/practical stages that are opened to physicists, radiotherapists and nuclear physicians.

 
 

Archipedale Santa Maria Nuova

 
     
  Patient History  
 
 
 

Female - 57 years old - 167cm - 65kg

 
 

This patient is undergoing PET staging before surgery.

 
 

29th August 2007: Whole-body PET/CT positive

 
 

1st September: Whole-body bone scintigraphy negative

 
  3rd September: Sentinel lymph node positive  
     
     
  Acquisition  
 
 
 

Scanner: GE Discovery STE

 
     
  PET acquisition: Whole-body acquisition  
  3D acquisition  
  Acquisition time: 2 min 30 per bed position  
  Dose: 240 MBq of 18F-FDG  
       
  CT acquisition: Whole-body acquisition  
  kVp: 120 - mA: 80  
       
     
  Findings  
 
 
 
Fused coronal view shows focal uptake in right axillary node
 
Pre-surgery VR showing axillary node 3D position and primary lesion  

Fused coronal view shows focal uptake in right axillary node

 

Pre-surgery VR showing axillary node 3D position and primary lesion

 
Axial fused view of the primary lesion      

Axial fused view of the primary lesion

     
 
 
Fused Axial view of right axillary node
 
Fused Coronal view of right axillary node  

Fused Axial view of right axillary node

 

Fused Coronal view of right axillary node

 
     
 
  PET is positive for the primary lesion in the right breast.  
  Increased FDG uptake in little right axillary lymph node. Biopsy confirmed a 3mm micrometastasis.  
     
     
  Conclusion  
 
 
 

The lesion showed by the “other modality” was confirmed in the right breast.

 
 

PET pointed out the presence of a 3mm micrometastasis in the right axillary, and changed the final staging and hence the therapy choice.

 
   
 
Axial fused view of the primary lesion
 
   
   
   
   
   
   
     
Who we are  
Patient History  
Acquisition  
Findings  
Conclusion