PET - Positron Emission Tomography

On June 11, 2013, the Centers for Medicare and Medicaid Services (CMS) issued a National Decision Memorandum to end the Coverage with Evidence Development (CED) requirement for FDG oncologic PET scans, which necessitated entry of studies for certain tumor types (under subsequent treatment strategies) to the National Oncologic PET Registry (NOPR). Tumor types included in this category are brain, pancreas, small cell lung cancer, soft tissue sarcoma, testes, as well as “all other solid tumors” and “all other cancers not listed.

 

PET (Positron Emission Tomography) is an imaging technique used to detect body functions on the cellular level.  This may help detect cancers and determine appropriate management and care of treatment plans.

 

Washington Health System Washington Hospital has been a leader in PET imaging since the technology gained widespread acceptance in the late 1990’s. Initially, Washington Health System Washington Hospital invested in coincidence imaging.  This technology was upgraded in 2002 to a dedicated PET scanner – providing Washington County residents with technology that was considered to be the standard of care for its time.  As PET technology evolved, Washington Health System Washington Hospital partnered with UPMC to upgrade its equipment. In 2007, The Washington Hospital upgraded its PET scanner to a combined PET and CT unit – the GE Discovery Lightspeed 16.  This partnership with UPMC - combined with the expertise of the Board certified Nuclear Medicine physicians interpreting PET/CT allows the residents of Washington County to receive the highest quality of care, close to home. 

 

PET/CT (Positron Emission Tomography combined with Computed Tomography) provides a powerful weapon in the fight against cancer. This high tech device is capable of communicating with the radiation therapy planning equipment, enabling the most accurate information to aid in the diagnosis, monitoring and treatment of oncologic disease. PET/CT can detect cancer cells as small as one centimeter that may not be clearly identified with conventional technology such as computed tomography (CT) scanning alone or magnetic resonance imaging (MRI). Physicians are using PET/CT to diagnosis and plan treatment of cancers, such as lymphoma, colorectal, melanoma, breast, lung and other cancers. The Washington Hospital has also joined a national PET registry. This allows some patients to receive coverage for scans that may not be approved by their insurance carriers.

 

PET/CT is performed at the hospital in the Nuclear Medicine Department. The medical and technical staff of the hospital have 12 years of experience performing PET examinations. The physicians interpreting PET and Nuclear medicine scans at the hospital are board certified in Nuclear Medicine with combined experience of over 20 years. 

 

 "The GE Discovery Lightspeed 16 provides a technologically advanced tool for use in diagnostic imaging," said William Castro, M.D., medical director Nuclear Medicine at Washington Health System Washington Hospital.  “PET/CT imaging complements imaging studies we are currently performing and offers a broad range of applications for new studies including the detection of Alzheimer’s disease and some cardiac disease also. The Discovery LightSpeed 16 will be extremely important in the evaluation of cancer patients and will allow physicians to enhance patient care and improve the management of their patients with cancer,” he said.

 

According to Dr. Castro, PET/CT  technology is based on cancer tumors’ taste for glucose (or sugar). Patients are required to fast for 4 hours prior to the exam and are then injected with a small amount of a radioactive substance that contains glucose. During the PET scan, the cancer cells absorb more of the glucose than normal cells and they show up as "hot" spots on the image of the portion of the body being scanned. "The important difference is that, with conventional imaging technology, we see only the outline of a tumor. With PET, we can actually see a physiological process," explained Dr. Castro.  Combining the PET image with a CT scan performed at the same time adds a level of precision that provides patients with the highest level of care and improves the accuracy of diagnosis. PET can also help physicians “stage” a tumor or determine its progression, and know whether treatment of the tumor is effective.

 

How does PET work?

A small amount of radioactive material which is tagged to a glucose compound is injected into the patient.  This injection will be picked up by the heart, brain and cancerous tumors.  The patient is then scanned from the head to thighs.  The computer reconstructs the  information acquired to form images of the body showing abnormal areas of radioactivity which may represent cancerous tumors.

 

When is PET used?

Pet is approved to evaluate the following diseases but not limited to these as additional cancers are approved.

  • Lung Cancer
  • Brain Tumor
  • Ovarian Cancer
  • Lymphomas
  • Colorectal Cancer
  • Pancreatic Cancer
  • Melanoma
  • Head & Neck Cancer
  • Breast Cancer

 

How Do I Prepare For My Scan?

  • Plan on being at the hospital for 2 to 2 1/2 hours.
  • Do not eat anything after midnight.
  • Drink 3-4 8 ounce glasses of water
  • If you have medicines to take you may do so with a small amount of water.
  • Register in the Admitting Office on the main floor 15-30 minutes prior to your appointment.
  • Upon arrival in Nuclear Medicine you will have an IV plug inserted in your arm and your blood sugar level will be measured.

  • You will be injected with a radioactive material and then asked to relax in the PET waiting room for one hour.

  • You will then be asked to lie quietly on the scan table as your pictures are acquired. The scan will take approximately 45 minutes.

 

Contact the PET Department directly at (724) 229-2076.