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HYBRID IMAGING. HYBRID IMAGING. Combination Nuclear medicine Radiology PET/CT Positron emission tomography Computed tomography SPECT/CT Single photon emission tomography Computed tomography PET/MRI. Beta plus decay. Nucleus reach of protons Proton is transformed to neutron - PowerPoint PPT Presentation
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HYBRID IMAGINGHYBRID IMAGING
HYBRID IMAGINGHYBRID IMAGING Combination Combination
Nuclear medicineNuclear medicine Radiology Radiology
PET/CTPET/CT Positron emission tomographyPositron emission tomography Computed tomographyComputed tomography
SPECT/CTSPECT/CT Single photon emission tomographySingle photon emission tomography Computed tomographyComputed tomography
PET/MRIPET/MRI
e-
e+
Beta plus decayBeta plus decay Nucleus reach of protonsNucleus reach of protons Proton is transformed to neutronProton is transformed to neutron Emission of positron and neutrinoEmission of positron and neutrino Periodical table shift to the left by one sitePeriodical table shift to the left by one site
18F to18O18F to18O Positron is living only few msPositron is living only few ms Annihilation of the matterAnnihilation of the matter Interaction of electron and positronInteraction of electron and positron Gamma raysGamma rays
2 quanta E – 511 keV 2 quanta E – 511 keV Unique energyUnique energy Angle180oAngle180o
180
511 keV
511 keV18F
PET/CT scannerPET/CT scanner
RadiopharmaceuticalsRadiopharmaceuticals 18F halftime110 min18F halftime110 min
18FDG – fluorodeoxyglucose18FDG – fluorodeoxyglucose 18FLT – fluorothymidine 18FLT – fluorothymidine Na18FNa18F 18F-Estradiol, 18F-methionin, 18F-DOPA, 18F-cholin18F-Estradiol, 18F-methionin, 18F-DOPA, 18F-cholin
68Ga halftime 68 min68Ga halftime 68 min DOTA derivatesDOTA derivates somatostatine analogasomatostatine analoga
11C halftime 20 min11C halftime 20 min 11C-acetate, 11C-cholin 11C-acetate, 11C-cholin
13N (9 min), 15O (123 s), 82Rb (78 s)13N (9 min), 15O (123 s), 82Rb (78 s)
Imaging techniqueImaging technique Application of radiofarmakaApplication of radiofarmaka Oral preparationOral preparation
1000 ml 2,5% manitol1000 ml 2,5% manitol CT data acquisitionCT data acquisition PET data acquisitionPET data acquisition
7 positions per 3 min7 positions per 3 min
2,5% mannitol2,5% mannitol
Oral preparationOral preparation
Postprocessing fusion CT + Postprocessing fusion CT + PETPET
Multiple colorectal cancerMultiple colorectal cancer
1818F-fluorodeoxyglucoseF-fluorodeoxyglucose
plasma cell
transport phosphorylation glycolysis
glucoseglucose
1818F-FDGF-FDG 1818F-FDG-6-PF-FDG-6-P
glucose-6-Pglucose-6-Pglycolysis
glucoseglucose
1818F-FDGF-FDG
1818FDG-PET/CTFDG-PET/CT
Increased uptakeIncreased uptake Tumorous tissues with increased glycolytic activityTumorous tissues with increased glycolytic activity Inflammatory reactionInflammatory reaction
Physiological uptakePhysiological uptake brainbrain Brown fatty tissueBrown fatty tissue Stripped musclesStripped muscles Kidneys Kidneys Sallivary glandsSallivary glands
stagingstaging Bronchogenic carcinomaBronchogenic carcinoma Head and neck tumoursHead and neck tumours Lymfoma Lymfoma MelanoblastomaMelanoblastoma
BRCABRCA
BRCABRCA
Cerebral lymphomaCerebral lymphoma
Hodgkin diseaseHodgkin disease
Therapy strategyTherapy strategySarcoma tendinis Achill.Sarcoma tendinis Achill. LeiomyosarkomaLeiomyosarkoma Synovial sarcomaSynovial sarcoma
RestagingRestaging Therapy response effectTherapy response effect
DefinitiveDefinitive In the middle between cyclesIn the middle between cycles
Oropharyngeal cancerOropharyngeal cancer
18 months after
Early after Early after surgerysurgery
3 months later3 months later
Cervical cancerCervical cancer
Before thBefore th After thAfter th
myommyom
myommyom
CaCaCaCa
GradingGrading the assesment of the biologic activitythe assesment of the biologic activity More dedifferenciated – higher FDG More dedifferenciated – higher FDG
uptakeuptake
Low-grade astrocytomaLow-grade astrocytoma
Anaplastic oligodendrogliomaAnaplastic oligodendroglioma
Fever of unknown originFever of unknown origin
M. Hodgkin M. Hodgkin
Blastic turnover of the osteomyelofibrosisBlastic turnover of the osteomyelofibrosis
Microscopic polyarteritisMicroscopic polyarteritis
1818F-fluorothymidineF-fluorothymidine replication DNA = cellular proliferationreplication DNA = cellular proliferation
Fast dividing cellsFast dividing cells Tumors Tumors Bone marrowBone marrow Germinative zones of lymph nodesGerminative zones of lymph nodes Therapy monitoring – RT, CHTTherapy monitoring – RT, CHT
indicationsindications
1818F-natriumfluorideF-natriumfluoride Bone turnoverBone turnover
fluoroapatitefluoroapatite Osteoblastic activityOsteoblastic activity Osteoplastic bone metastasesOsteoplastic bone metastases
Ca prostateCa prostate Ca breastCa breast Ca lungsCa lungs
Bony tumorsBony tumors
Indications Indications