HYBRID IMAGING.  Combination  Nuclear medicine  Radiology  PET/CT  Positron emission tomography  Computed tomography  SPECT/CT  Single photon.

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Presentation transcript:

HYBRID IMAGING

 Combination  Nuclear medicine  Radiology  PET/CT  Positron emission tomography  Computed tomography  SPECT/CT  Single photon emission tomography  Computed tomography  PET/MRI

e-e- e+e+ Beta plus decay  Nucleus reach of protons  Proton is transformed to neutron  Emission of positron and neutrino  Periodical table shift to the left by one site  18F to18O  Positron is living only few ms  Annihilation of the matter  Interaction of electron and positron  Gamma rays  2 quanta E – 511 keV  Unique energy  Angle180o keV   18 F

PET/CT scanner

Radiopharmaceuticals  18F halftime110 min  18FDG – fluorodeoxyglucose  18FLT – fluorothymidine  Na18F  18F-Estradiol, 18F-methionin, 18F-DOPA, 18F-cholin  68Ga halftime 68 min  DOTA derivates  somatostatine analoga  11C halftime 20 min  11C-acetate, 11C-cholin  13N (9 min), 15O (123 s), 82Rb (78 s)

Imaging technique  Application of radiofarmaka  Oral preparation  1000 ml 2,5% manitol  CT data acquisition  PET data acquisition  7 positions per 3 min

2,5% mannitol Oral preparation

Postprocessing fusion CT + PET Multiple colorectal cancer

18 F-fluorodeoxyglucose plasmacell transportphosphorylationglycolysis glucose 18 F-FDG 18 F-FDG-6-P glucose-6-P glycolysis glucose 18 F-FDG

18 FDG-PET/CT  Increased uptake  Tumorous tissues with increased glycolytic activity  Inflammatory reaction  Physiological uptake  brain  Brown fatty tissue  Stripped muscles  Kidneys  Sallivary glands

staging  Bronchogenic carcinoma  Head and neck tumours  Lymfoma  Melanoblastoma

BRCA

BRCA

Cerebral lymphoma

Hodgkin disease

Therapy strategy Sarcoma tendinis Achill. Leiomyosarkoma Synovial sarcoma

Restaging  Therapy response effect  Definitive  In the middle between cycles

Oropharyngeal cancer 18 months after

Early after surgery 3 months later

Cervical cancer Before th After th myom myom Ca Ca

Grading  the assesment of the biologic activity  More dedifferenciated – higher FDG uptake

Low-grade astrocytoma

Anaplastic oligodendroglioma

Fever of unknown origin M. Hodgkin

Blastic turnover of the osteomyelofibrosis

Microscopic polyarteritis

18 F-fluorothymidine  replication DNA = cellular proliferation  Fast dividing cells  Tumors  Bone marrow  Germinative zones of lymph nodes  Therapy monitoring – RT, CHT

indications

18 F-natriumfluoride  Bone turnover  fluoroapatite  Osteoblastic activity  Osteoplastic bone metastases  Ca prostate  Ca breast  Ca lungs  Bony tumors

Indications