Oncology and PET/CT Gallery

With the exceptions of specific tumour types, NM has a limited role as a first-line diagnostic procedure. Instead, it is fundamental for the staging assessment of patients after the initial diagnosis of cancer has been established. Staging is crucial to assess prognosis and/or to select the most appropriate treatment(s) (surgery, adjuvant or neo-adjuvant therapy, combined regimens, radiotherapy). In this context, PET is the most important NM application and has become the standard of practice for many types of cancer.

Radionuclide imaging (especially PET) does not rely purely on static morphologic alterations, as is the case for CT and MRI, but rather identifies neoplastic alterations down to the metabolic level. Metastatic disease, for instance, can be identified earlier on PET. Such metabolic-functional characterization is important for assessing the efficacy of anti-tumour therapy as well as, during follow-up, for further characterizing abnormalities noted on morphologic imaging. For example,  nonspecific post-treatment changes like scarring are often morphologically indistinguishable from tumour recurrence on CT or MRI. Metabolic assessment with PET can often help.

In addition, therapeutic applications of nuclear medicine are now expanding from a core of well-established procedures (such as radioiodine therapy in differentiated thyroid cancer, palliation of bone pain from skeletal metastases using bone-seeking agents, therapy of neuroblastoma or pheochromocytoma with 131I-MIBG) to newer applications covering a wider range of treatable malignacies such as radioimmunotherapy of lymphomas, receptor-mediated therapy of neuroendocrine tumours with radiolabeled somatostatin analogues, PSMA-mediated therapy of patients with metastatic prostate cancer, etc).