PET –PET –POSITRON EMISSION POSITRON EMISSION

TOMOGRAPHYTOMOGRAPHY

PET: PET: POSITRON POSITRON EMISSION EMISSION

TOMOGRAPHYTOMOGRAPHY

Izot.

Radiotracer Mecanism

18F 18F FDG (90%) Glucidic Metabolism18F-Fluoro-Dopa dopaminergic Sintesys18F-Fluoro-misonidazole

Tumoral Hipoxia

18F-Uracil (FU) Chimioterapy evaluation (5FU)18F FLT FluoroTimidin

Cellular Proliferation

15O H²O15 Perfusion11C 11C-Acetat Oxidativ Metabolism (miocardic +

tumoral)11C-Palmitat Miocardic Metabolism (acizi graşi)11C-Tirozin Tumoral Metabolism11C-Timidin Cellular Proliferation11C-Metionin Tumoral Metabolism11C-Colin Tumoral Metabolism11C-Acid-Amino-IsoButiric

Tumoral Metabolism

11C-Acid-Amino-Ciclopentan-Carboxilic (ACPC)

Tumoral Metabolism

13N 13N-NH3 (amoniac) Miocardial Perfusion13N-Glutamat Tumoral Metabolism

Most used PET radiotracers

PETprinciple

Unstable nucleus

positronantiparticle of the electron (same charge, opposite semn)

electron

positronium

2 gamma photons, 511 keV

Coincidence detection(interval 10-9 sec.)

detector: Bi germanat crystal(BGO)Photomultipliers around

Anihilation process

Desintegration throughpositron emission

Anihilationelectron/positron

Anihilationphoton

Anihilationphoton

Device

The germinating idea of PET: The germinating idea of PET: Nobel Prize Medicine Laureat, Dr. Otto Warburg:Nobel Prize Medicine Laureat, Dr. Otto Warburg: <The prime cause of cancer is the replacement of the <The prime cause of cancer is the replacement of the

respiration of oxygen by normal body cells by a respiration of oxygen by normal body cells by a fermentation of sugar> fermentation of sugar>

PET: analogs metabolicGlucidic Metabolism

Glicolisys in malignant cell

GLUT8

GLUT6

GLUT transporters

1818FFDG FFDG ((1818F-2fluoro-F-2fluoro-

2deoxi-Dglucose)2deoxi-Dglucose)

PET IndicatiPET Indicationon

MiocardiMiocardial al Scintigra Scintigraphyphy TumoralTumoral Scintigra Scintigraphyphy : : pulmonar neoplasmpulmonar neoplasm mamarmamaryy neoplasm neoplasm cerebral neoplasmcerebral neoplasm ovarianovarian gastrointestinal neoplasgastrointestinal neoplasiaia limlimphphomomaa Head-neck Head-neck tumortumorss endocrin tumorendocrin tumorss : t : thyhyroidian, carcinoid, roidian, carcinoid,

phpheocromocitomeocromocitomaa

Normal 18FFDG PET imageNormal 18FFDG PET image

Normal PET and PET-CT images

Pathologic Pathologic 1818F FDG F FDG PET images in cancerPET images in cancer

Lung cancerLung cancer

Lung cancer Lung cancer with metastaseswith metastases

Hodgkin Hodgkin lymphoma with lymphoma with metastasesmetastases

MelanomaMelanoma

PET-CT images

CTPET PET - CT

Imagini PET (18FFDG), CT şi PET-CT normale (secţiuni coronale)

PET + CT = PET-CT