From the Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA.
Department of Radiology, University of California, Davis, Sacramento, CA.
Clin Nucl Med. 2022 Jan 1;47(1):43-55. doi: 10.1097/RLU.0000000000003962.
The introduction of total body (TB) PET/CT instruments over the past 2 years has initiated a new and exciting era in medical imaging. These instruments have substantially higher sensitivity (up to 68 times) than conventional modalities and therefore allow imaging the entire body over a short period. However, we need to further refine the imaging protocols of this instrument for different indications. Total body PET will allow accurate assessment of the extent of disease, particularly, including the entire axial and appendicular skeleton. Furthermore, delayed imaging with this instrument may enhance the sensitivity of PET for some types of cancer. Also, this modality may improve the detection of venous thrombosis, a common complication of cancer and chemotherapy, in the extremities and help prevent pulmonary embolism. Total body PET allows assessment of atherosclerotic plaques throughout the body as a systematic disease. Similarly, patients with widespread musculoskeletal disorders including both oncologic and nononcologic entities, such as degenerative joint disease, rheumatoid arthritis, and osteoporosis, may benefit from the use of TB-PET. Finally, quantitative global disease assessment provided by this approach will be superior to conventional measurements, which do not reflect overall disease activity. In conclusion, TB-PET imaging may have a revolutionary impact on day-to-day practice of medicine and may become the leading imaging modality in the future.
过去 2 年中，全身（TB）PET/CT 仪器的引入开创了医学成像的新时代。这些仪器的灵敏度比传统设备高得多（高达 68 倍），因此可以在短时间内对整个身体进行成像。然而，我们需要进一步完善该仪器的成像方案，以满足不同的适应症。全身 PET 可准确评估疾病的范围，特别是包括整个轴向和四肢骨骼。此外，该仪器的延迟成像可能会提高某些类型癌症的 PET 敏感性。此外，这种方式还可以提高四肢癌症和化疗常见并发症静脉血栓形成的检出率，并有助于预防肺栓塞。全身 PET 可评估全身动脉粥样硬化斑块，作为系统性疾病。同样，患有广泛的肌肉骨骼疾病的患者，包括肿瘤和非肿瘤性疾病，如退行性关节疾病、类风湿关节炎和骨质疏松症，都可能受益于全身 PET。最后，该方法提供的定量整体疾病评估将优于传统的测量方法，后者不能反映整体疾病活动度。总之，全身 PET 成像可能会对医学的日常实践产生革命性的影响，并可能成为未来的主要成像方式。
