In this episode, I’m going to discuss head and neck cancer, including normal variations, clinical indications, and my favorite topic, radiation therapy planning with PET. Head and neck cancer is not as common as other cancers, but the high morbidity and mortality rates make it an important topic. I’ll also discuss the patient preparation and overall procedure used at our site with head and neck cases.
As we continue our discussion of lung cancer, I want to cover how radiation therapy and PET are becoming linked. I’ll discuss the three key volumes used for any plan, the most important of which is the Gross Tumor Volume (GTV) that the therapist delineates using imaging. In lung cancer, PET can have a particular influence on the size of the GTV, either by increasing or decreasing this volume. For example, PET can detect regional lymph nodes in non-small cell lung cancer patients.
Today I’m going to continue my discussion of PET and lung cancer by going through a number of interesting studies. I’ve spoken before about the pitfalls of SUV, but there is research that shows that the SUV combined with Hounsfield units can be very helpful when studying adrenal lesions. Due to a lack of standardized criteria, it is difficult to completely quantify PET’s ability to help categorize patient response, yet the data shows that PET is very useful in therapy response and predicting patient survival.
Today I’ll continue my discussion of PET and lung cancer. The SUV can be a valuable tool to use as a baseline and for follow-up, but essentially an SUV measurement on its own isn’t really better than visual analysis. I’ll discuss the various pitfalls of SUV, as well as tips for examining both solitary pulmonary nodules and the mediastinum.
In this episode, I will discuss the history of approved reimbursements from CMS, from the 1998 approval for solitary pulmonary nodules to more recent changes in terminology that affect our billing. Lung cancer has a high mortality rate in both men and women, and the current statistics on the subject are striking. I will also go into detail about how our site uses PET with lung cancer cases.
In this follow-up to Pediatric PET, I’ll move to discussing specific applications and disease states. In pediatrics, it is particularly important to minimize dose, since the patient will hopefully have many more years to live. I’ll talk about how standalone PET, and the new developments in PET/MR, can potentially help reduce the frequency of using diagnostic CT.
Today I want to talk about pediatric PET, and the issues we encounter before any images even get to the radiologist. It may sound simplistic, but children are not little adults, and often patient sedation is required. Because of this, it’s best to coordinate exams close to each other in time, and in the same room if possible. Overall, we want to minimize sedation time, dose, delays between scans, and patient discomfort. And of course, don’t forget about the parents!
In this third look at fusing anatomic and physiological data, I want to examine why SPECT/CT has not enjoyed the popularity of PET/CT. SPECT/CT can offer many of the same benefits as PET/CT, such as improved image quality, and it has some interesting brachytherapy applications, Later in this podcast, I will also examine the future of PET/MR.
In this episode, I continue my discussion of the advancements made by hardware fusion. The adoption of the combined PET/CT instrument gave us dramatic decreases in imaging time, reduced dose, and most importantly, gains in image quality. Even with these advancements, software fusion remains important for the future, since it allows comparison of images from different time points.
We’ve already benefited a great deal from fusion thanks to the clinical context it provides for surgery and radiation therapy. In this episode, I’m going to discuss both software and hardware fusion and the advancements made by these techniques. Software techniques have improved with deformable registration, and the combined instrument in hardware is really very useful for improving image quality.
