Dr. Lengyel Zsolt. Budapest. Worldnumbers.com: PET and PET/CT Are the Fastest Growing Imaging Modalities Worldwide

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1 Worldnumbers.com: PET and PET/CT re the Fastest Growing Imaging Modalities Worldwide Dr. Lengyel Zsolt Budapest ENM: PET and PET/CT scans grow by 21% a year The development of PET and PET/CT examinations in Denmark with FDG and tracers other than FDG. Since 2005 the average annual increase in FDG PET and FDG PET/CT has been 55% PET & PET/CT examinations per million population in Source: Development of PET in Western Europe, nthony Stevens, PhD, ENM PET/CT represents one of the medical imaging modalities with the largest growth worldwide. In 2009, approximately 2,000 PET/CT scanners were installed in the United States and approximately 350 were installed in Europe. Considering a population of about 307 million in the United States and 830 million in Europe, the United States has installed about 6 times as many scanners as all of Europe but has only one third the population. (Courtesy of Siemens/CTI.) The purpose of this publication is to develop a consensus based on evidence from existing systematic reviews, to make health care providers aware of the value and the appropriateness of the introduction of positron emission tomography (PET), either alone or in combination with computed tomography (PET/CT) using 2-fluoro-2-deoxy- D-glucose (FDG) labelled with 18F, in the management of patients affected by cancer.

2 Staging Restaging -up) - lkalmas Esetlegesen alkalmas Nem alkalmas tumor- emelkedett tumor- : : - E Esetlegesen alkalmas: Nem alkalmas: Nem- SPN 1 cm- - 78%-

3 NSCLC PET 85% CT 57% PET 90% CT 82% -a - - -tel. NSCLC - vagy radio- - vagy radio- alatt NSCLC NSCLC - Hodgkin- -Hodgkin -grade vele. - staging-

4 - - tumorokra. xilla ban lehet - a CT-n Melanoma malignum - -

5 Melanoma malignum -es Melanoma malignum Melanoma malignum - biopszia staging-ben hasznos. Minden intervallum- (az esetek 8-14%- kimenetelt. -

6 PET- UH-val vagy CT- - - PET-- PET a CT- vagy kemo- rendszerint a CT- z FDG PET a CT- hasznos. -

7 Sigma cc. loc. rec. biopszia - PET a CT- vagy kemo- tervezett. - gyomor FDG- mucosa lymphoid sejtek secretum??? Mintegy 30% nem FDG-avid Metabolizmus: GLUT- FDG gyomor malignus tumorainak FDG- nem intestinalis - alacsony (T3,T4) csak 60%! (Stahl, EJNM 2003) Ott et al. Gastrointest Cancer Res 2008;2:287-94

8 - FDG- 30 p= p= intestinalis SUV [BS] Nem intestinalis 10 5 nem- mucinosus mucinosus G2 G3 PET CT Lim et al. RadioGraphics 2006; 26: Stahl et al. Eur J Nucl Med Mol Imaging 2003;30: GIST -re a tumor FDG- - FDG- - Mivel a GIST- - GIST GIST tumor- Staging B C -

9 FDG- 7 napos Van den bbeele,.d., for the GIST Collaborative PET Study Goup (Dana-Farber Cancer Institute, Boston, Massachusetts, US, OSU, Portlat, Oregon, Helsinki University Central Hopital, Turku University Central Hospital, Finland, Novartis Oncology). F18-FDG-PET provides early evidence of biological response to ST1571 patients with malignant gastrontestinal stromal tumors (GIST). Proc. m. Soc. Clin. Oncol :362a. - -staging- - PET a CT- tumor FDG- -

10 - z FDG- - PET pontosabb a CT- - -staging-ben. PET a CT- - - GIST Staging X Restaging X X X X X* X X Staging Beteg- X X X X X X X X X X - X X X X X - X X X OEP- -) Fej- BNO csoport C00-C14, C30-C32 C70-72, D diagnosztika* Nem- Colorectalis carcinoma Lymphoma** Melanoma malignum C73H0 D3810, D3860, R91H0 C34 C15 C18-C21 C81-C85 C43 C50 C53 - G4000, G4030

11 Fej-nyaki daganatok PET- PET 30%- 5 mm- Fej-nyaki daganatok - szinkron tumort vagy kemo- z FDG- Fej-nyaki daganatok tumorok. Fej-nyaki daganatok - nincsenek adatok. PET az esetek 16,1%- terven. E - z iv. kontrasztos CT- -hez E

12 - - a mucinosus - -nek nincs haszna! - Ib- -. z ugyanakkor jobb a -. z - - NOPR szerint - 14,1, a - - E Nincs - z FDG- kimenetellel. z FDG- kimenetellel. - -PET jobb diagnosztikus - igazolta, hogy az FDG- - -PET - Fej- BNO csoport C00-C14, C30-C32 C70-72, D diagnosztika* Nem- Colorectalis carcinoma Lymphoma** Melanoma malignum OEP- - - C73H0 D3810, D3860, R91H0 C34 C15 C18-C21 C81-C85 C43 C50 C53 G4000, G4030

13 -re? Diagnosztikus CT: FDG- - -avid tumorok Bronchioloalveolaris carcinoma (~100%) -50%) -sejtes carcinoma (~100%) -40%) Primer prostata carcinoma (80-85%) Neuroendocrin daganatok (60-90%) Nem: Igen: CRC, fej- PET/CT -75%- -e a CT?

14 Pro: Kontra: - figyelmet!