PET/CT imaging

Clinical case - Improvement in staging confidence

   
 
     
  Who we are  
 
 
  Professor Juhani Knuuti
Director


Adj. Prof. Marko Seppänen
Diagnostic Service Manager


Turku PET Centre
Turku, Finland


As a Finnish National Research Institute, Turku PET Centre led by Professor J. Knuuti, promotes the use of PET in the medical research field. The Centre was founded in 1974 by the University of Turku, Åbo Akademi University and the Turku University Hospital. The Centre integrates top scientific expertise with excellent facilities and equipments. Fruitful interaction and collaboration between basic scientists and clinical investigators is a long-standing tradition.

 
 

The latest imaging technology is available, some unique in Europe. The Centre provides several tracers for routine and research clinical imaging in Oncology, Neurology and Cardiology, using the Europe's first 64 slices PET/CT system. With its excellent cyclotron and radiochemistry laboratories, Turku PET Centre develops and produces the latest PET tracers for clinical imaging.

 
  Turku  
     
  Patient History  
 
 
 

Female - 61 years old - 163cm - 69kg

The patient has been smoking since teenage. Suffered hemoptysis and, thereafter, diagnosed a squamocellular cancer in left lung (CT exam).

Referred to 18F-FDG PET/CT for staging purposes.

 
   
     
  Acquisition  
 
 
 

Scanner: GE Discovery VCT

 
     
  PET acquisition: Whole-body acquisition  
  3D acquisition using both VUE Point & VUE Point HD reconstructions  
  Acquisition time: 12 min  
  Post-injection time: 50 min  
  Dose: 315 MBq of 18F-FDG  
     
  CT acquisition: Low Dose with shallow breathing without contrast media  
  Rotation speed: 0.8 second  
  FOV: 70 cm  
  Pitch: 1.375 mm/rot  
  Slice thickness: 3.75 mm  
  Smart mA, NI: 25, kVp: 140, mA: 80  
  Dose: 2 mSv  
       
     
  Findings  
 
 
 
Matrix 128
 
Matrix 256
   
Matrix 128   Matrix 256
VUE Point:
Matrix of 128 x 128 pixels
  VUE Point HD:
Matrix of 256 x 256 pixels
       
 
 

There is a metabolically active tumour in the left upper lobe representing the primary tumour and one enlarged and active lymph node metastasis in left hiliar causing some atelectasis to the upper lobe. Another metabolically active small lesion was discovered in subcarinal space with suspicion of lymph node metastasis.

 
     
     
  Conclusion  
 
 
 

Using a matrix of 256x256 pixels improved the diagnostic confidence that the subcarinal lymph node is pathological. The primary tumour is also better delineated from the hiliar lymph node which may be beneficial for the radiotherapy planning and improve the staging when lymph node metastases are located close to the primary tumour, i.e. in oesophageal cancer. Finally, the use of integrated PET/CT technique enables the detection of viable tumour from atelectasis that can be seen on low dose CT images.

 
   
 
Matrix 128
 
   
   
   
   
   
   
     
Who we are  
Patient History  
Acquisition  
Findings  
Conclusion