Poeppel T D, Krause B J, Heusner T A, Boy C, Bockisch A, Antoch G
Department of Nuclear Medicine, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany.
Eur J Radiol. 2009 Jun;70(3):382-92. doi: 10.1016/j.ejrad.2009.03.051. Epub 2009 Apr 29.
Positron emission tomography (PET) and computed tomography (CT) complement each other's strengths in integrated PET/CT. PET is a highly sensitive modality to depict the whole-body distribution of positron-emitting biomarkers indicating tumour metabolic activity. However, conventional PET imaging is lacking detailed anatomical information to precisely localise pathologic findings. CT imaging can readily provide the required morphological data. Thus, integrated PET/CT represents an efficient tool for whole-body staging and functional assessment within one examination. Due to developments in system technology PET/CT devices are continually gaining spatial resolution and imaging speed. Whole-body imaging from the head to the upper thighs is accomplished in less than 20 min. Spatial resolution approaches 2-4mm. Most PET/CT studies in oncology are performed with (18)F-labelled fluoro-deoxy-D-glucose (FDG). FDG is a glucose analogue that is taken up and trapped within viable cells. An increased glycolytic activity is a characteristic in many types of cancers resulting in avid accumulation of FDG. These tumours excel as "hot spots" in FDG-PET/CT imaging. FDG-PET/CT proved to be of high diagnostic value in staging and restaging of different malignant diseases, such as colorectal cancer, lung cancer, breast cancer, head and neck cancer, malignant lymphomas, and many more. The standard whole-body coverage simplifies staging and speeds up decision processes to determine appropriate therapeutic strategies. Further development and implementation of new PET-tracers in clinical routine will continually increase the number of PET/CT indications. This promotes PET/CT as the imaging modality of choice for working-up of the most common tumour entities as well as some of the rare malignancies.
在一体化正电子发射断层扫描/计算机断层扫描（PET/CT）中，正电子发射断层扫描（PET）和计算机断层扫描（CT）优势互补。PET是一种高度灵敏的成像方式，可描绘出指示肿瘤代谢活性的发射正电子生物标志物的全身分布情况。然而，传统PET成像缺乏详细的解剖学信息，难以精确确定病理发现的位置。CT成像能够轻松提供所需的形态学数据。因此，一体化PET/CT是一种在一次检查中进行全身分期和功能评估的有效工具。由于系统技术的发展，PET/CT设备的空间分辨率和成像速度不断提高。从头部到大腿上部的全身成像可在不到20分钟内完成。空间分辨率接近2-4毫米。肿瘤学中的大多数PET/CT研究都使用（18）F标记的氟代脱氧-D-葡萄糖（FDG）。FDG是一种葡萄糖类似物，可被活细胞摄取并滞留其中。糖酵解活性增加是许多类型癌症的一个特征，导致FDG大量积聚。这些肿瘤在FDG-PET/CT成像中表现为“热点”。FDG-PET/CT在不同恶性疾病（如结直肠癌、肺癌、乳腺癌、头颈癌、恶性淋巴瘤等）的分期和再分期中被证明具有很高的诊断价值。标准的全身覆盖简化了分期过程，并加快了确定适当治疗策略的决策过程。新的PET示踪剂在临床常规中的进一步开发和应用将不断增加PET/CT的适应症数量。这促使PET/CT成为评估最常见肿瘤实体以及一些罕见恶性肿瘤的首选成像方式。
