Oncology

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.

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