In oncology, PET permits a physician to accurately image many organs of the body with a single scan in order to detect malignancy. PET has demonstrated usefulness in cost-effective whole-body metastatic surveys, avoiding biopsies. The benefits of PET include non-invasive differentiation of tumors from radiation necrosis, the possibility to change the course of ineffective chemotherapy and avoidance of unnecessary diagnostic and therapeutic procedures. Applications for PET in oncology include:
| Brain Tumor |
| Differentiate a recurrent tumor from radiation necrosis. |
| Differentiate primary CNS lymphoma from toxoplasmosis. |
| Exclude brain metastatic disease. |
| Breast Cancer |
| Identify involved axillary nodes or distant metastatic disease. |
| Exclude local recurrence of disease. |
| Evaluate response to treatment. |
| Colorectal Cancer |
| Detect locally recurrent or distant metastatic disease in patients with elevated or rising CEA who may be candidates for surgical re-excision. |
| Rule out distant metastases for preoperative evaluation. |
| Head & Neck Cancer |
| Determine extent of local, regional and distant disease. |
| Detect recurrent/residual tumor following definitive therapy. |
| Lung Cancer |
| Distinguish malignant pulmonary nodules from benign ones. |
| Stage mediastinal or distant metastatic disease. |
| Use as part of radiotherapy treatment planning. |
| Detect recurrent/residual tumor following definitive therapy. |
| Lymphoma |
| Determine extent of disease and measure treatment response. |
| Melanoma |
| Identify extent of local and regional disease spread in patients with high risk melanoma (e.g., primary tumor less than 4mm) or in suspected recurrence. |
| Musculoskeletal Tumors |
| Evaluate local extent of disease and exclude distant metastases. |
| Measure treatment response and exclude recurrent/residual tumor following definitive therapy. |
| Ovarian Cancer |
| Detect recurrent/residual tumor prior to surgical exploration or additional chemotherapy. |
| Pancreatic Cancer |
| Differentiation of benign processes such as pancreatitis, mucinous cyst adenoma and pseudocyst from malignant disease. |
| Rule out distant metastases during preoperative evaluation. |
| Thyroid Cancer |
| Detect metastatic or locally recurrent disease in patient with elevated thyroglobulin after definitive initial treatment and negative I-131 examination. |
| References |
| Conti, P.S., Lilien, D.L., Howley, K., Keppler, J., Grafton, S.T., Bading, J., PET and F-18 FDG in Oncology: A Clinical Update. Nuclear Medicine and Biology,(1996) 23:717-735. Di Chiro, G., Positron Emission Tomography Using FDG in Brain Tumors: A Powerful Diagnostic and Prognostic Tool. Investigational Radiology, (1986) 2:360-371. |
For more information on how PET can be used in oncology, please see the literature summary by disease type.
