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.