2. Lisa Rhoden (RT)(R) B.S. CNMT

3. PET PET permits investigation and comparison of events occurring at the molecular and cellular level. This data is not attainable by other modalities. PET is especially useful in the detection of cancer, coronary heart disease, and brain disease. The basis of PET is the positron The positron is a positively charged beta particle emitted from neutron-poor radionuclides. The result of this emission are annihilation photons that create 2 gamma rays of exactly 511 keV each, at 180 degrees to each other.

4. Positron Decay Annihilation - two photons - + 511 keV 180 o Positronium For more on Positron Decay click

5. Positron Decay  decay via positron emission electron/positron annihilation photon annihilation photon u The average distance a positron travels before annihilation is determined by the energy with which it leaves the nucleus  18 F = 0.22mm 

6. PET/CT vs. PET The ability to have the CT localization makes interpretations more accurate PET/CT has advantages to the patient in making the acquisition time shorter There is more accurate attenuation correction with PET/CT PET/CT Machine

7. Protocol: Dose Receiving Upon receiving a dose shipment from the pharmacy, the technologist must check it in This includes measuring the radioactivity in mR at the surface of the box and at one meter away. All measurements are recorded and kept

8. Protocol: Patient Prep (at UAMS) Patient is to be held NPO (with the exception of water) a minimum of six hours prior to injection time No insulin or Dextrose-5 should be given to the patient for a minimum of six hours prior to injection The patient may receive 5-10 mg of Valium before the injection is given The patient should be made comfortable and relaxed Did the patient follow the prep correctly? YES NO Did the patient follow the prep correctly? YES NO

9. Yes, the patient complied with the preparation Since the patient followed the proper protocol, the scan may continue without further concerns once the blood sugar is taken

10. If the patient was not NPO Determine what, when and much was consumed Obtain a blood glucose level Consult with the physician on call with results If the patient had insulin or D5 Determine how much, at what time it was started, and what time it was discontinued Obtain a blood glucose level Consult with the physician on call with results If the patient can not have Valium Consult the physician on call for further instructions or alternatives No, the patient did not comply with the preparation

11. Protocol: Blood Glucose Level A blood glucose level will be obtained prior to injection and recorded Optimum blood glucose level is below 150 mg/dL Below 150 mg/dL Above 150 mg/dL Select the patient’s blood glucose level

12. Below 150 mg/dL This is an acceptable range to continue the procedure

13. Above 150 mg/dL This is NOT an acceptable range to continue the procedure Determine if the patient is diabetic and call the physician

14. Next: Assay the Dose The tech will then do background counts and a wipe test Next the dose will be assayed, or measured for radioactivity in the dose calibrator

15. Protocol: Isotope Injection An IV will be started and used to administer the radioactive tracer Patient will wait 2-3 hours to allow the isotope to be taken into the cells

16. Protocol Cont. Patient will drink approximately 300 cc of contrast containing Omnipaque (iohexol) 300 mgI/ml Remove metallic objects Empty bladder

17. Protocol Cont. Position for scanning Patient position will be determined based on area being scanned

18. Data Acquisition and Processing

19. Colorectal Carcinoma CT CT PET PETFUSED

20. Breast Cancer CTPETFused

21. Review Basic PET Process Isotope production (cyclotron) Tracer labeling (radiochemistry) Tracer injection & data acquisition Image reconstruction Interpretation Data synthesis

22. Thank you for your time Questions? Want more? For questions or concerns regarding PET/CT scanning and procedures please send me an email by clicking the button below If you would like more information on this topic and other related topics, please go to the website by clicking the button below