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The clinical application of PET/CT: a contemporary review

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Abstract

The combination of positron emission tomography (PET) scanners and x-ray computed tomography (CT) scanners into a single PET/CT scanner has resulted in significant improvements in the diagnosis and staging of disease, particularly in the field of oncology. A decade on from the publication of the details of the first PET/CT scanner, we review the technology and applications of the modality. We examine the design aspects of combining two different imaging types into a single scanner, and the artefacts produced such as attenuation correction, motion and CT truncation artefacts. The article also provides a discussion and literature review of the applications of PET/CT to date, covering detection of tumours, radiotherapy treatment planning, patient management, and applications external to the field of oncology.

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References

  1. O’Connor, M. K. and Kemp, B. J.,Single-photon emission computed tomography/computed tomography: basic instrumentation and innovations, Semin. Nucl. Med., 36: 258–266, 2006.

    Article  PubMed  Google Scholar 

  2. Ambrose, J. and Hounsfield, G. N.,Computerized transverse axial tomography, BJR., 46: 148–149, 1973.

    Article  PubMed  CAS  Google Scholar 

  3. Hounsfield, G. N.,Computerized transverse axial scanning (tomography): Part 1. Description of system, BJR., 46: 1016–1022, 1973.

    Article  PubMed  CAS  Google Scholar 

  4. Muehllehner, G. and Karp, J. S.,Positron emission tomography, Phys. Med. Biol., 51: R117-R137, 2006.

    Article  PubMed  CAS  Google Scholar 

  5. Townsend, D., Beyer, T., Kinahan, P. E., Brun, T., Roddy. R., Nutt, R. and Byars, G.,The SMART Scanner: a Combined PET/CT Tomograph for Clinical Oncology, IEEE Nucl. Sci. Symp. Conf. Rec., 1170, 1998.

  6. Beyer, T., Townsend, D. W., Brun, T., Kinahan, P. E., Charron, M., Roddy, R., Jerin, J., Young, J., Byars, L. and Nutt, R.,A Combined PET/CT Scanner for Clinical Oncology, J. Nucl. Med., 41: 1369–1379, 2000.

    PubMed  CAS  Google Scholar 

  7. Tai, Y.-C., Chatziioannou, A. F., Yang, Y., Silverman, R. W., Meadors, K., Siegel, S., Newport, D. F., Stickel, J. R. and Cherry, S. R.,MicroPET II: design, development and initial performance of an improved microPET scanner for small animal-imaging, Phys. Med. Biol., 48: 1519–1537, 2003.

    Article  PubMed  Google Scholar 

  8. 8.Yang, Y., Tai, Y.-C., Siegel, S.,Newport, D. F., Bai, B., Li, Q., Leahy, R. M. and Cherry, S. R.,Optimization and performance evaluation of the microPETII scanner for in vivo small-animal imaging, Phys. Med. Biol., 49: 2527–2545, 2004.

    Article  PubMed  Google Scholar 

  9. Liang, H., Yang, Y., Yang, K., Wu, Y., Boone, J. M. and Cherry, S. R.,A microPET/CT system for in vivo small animal imaging, Phys. Med. Biol., 52: 3881–3894, 2007.

    Article  PubMed  CAS  Google Scholar 

  10. Kalender, W. A.,Computed Tomography: Fundamentals, System Technology, Image Quality, Applications, 2nd Edition, Wiley-VCH, 13: 978-3895782169, 2004.

  11. Wernick, M. N. and Aarsvold, J. N.,Emission Tomography: The Fundamentals of PET and SPECT: The Fundamentals of Pet and Spect, Academic Press, 13: 978-0127444826, 2004.

  12. Townsend, D. W.,Multimodality imaging of structure and function, Phys. Med. Biol., 53: R1-R39, 2008.

    Article  PubMed  CAS  Google Scholar 

  13. Zanzonico, P.,Positron emission tomography: a review of basic principles, scanner design and performance, and current systems, Semin. Nucl. Med., 34: 87–111, 2004.

    Article  PubMed  Google Scholar 

  14. Surti, S., Kuhn, A., Werner, M. E., Perkins, A. E., Kolthammer, J. and Karp, J. S.,Performance of a Philips Gemini TF PET/CT Scanner with Special Consideration for Its Time-of-Flight Imaging Capabilities, J. Nucl. Med., 48: 471–480, 2007.

    PubMed  Google Scholar 

  15. Karp, J. S., Surti, S., Daube-Witherspoon, M. E. and Muehllehner, G.,Benefit of Time-of-Flight in PET: Experimental and Clinical Results, J. Nucl. Med., 49: 462–70, 2008.

    Article  PubMed  Google Scholar 

  16. Ohi, J. and Tonami, H.,Investigation of a whole-body DOI-PET system, NIM A, 571: 223–226, 2007.

    Article  CAS  Google Scholar 

  17. Pichler, B. J., Swann, B. K., Rochelle, J., Nutt, R. E., Cherry, S. R. and Siegel, S. B.,Lutetium oxyorthosilicate block detector readout by avalanche photodiode arrays for high resolution animal PET, Phys. Med. Biol., 49: 4305–4319, 2004.

    Article  PubMed  CAS  Google Scholar 

  18. Pichler, B. J., Judenhofer, M. S., Catana, C., Walton, J. H., Kneilling, M., Nutt, R. E., Siegel, S. B., Claussen, C. D. and Cherry, S. R.,Performance test of an LSO-APD Detector in a 7-T MRI Scanner for Simultaneous PET/MRI, J. Nucl. Med., 47: 639–647, 2006.

    PubMed  Google Scholar 

  19. Yamamoto, S., Matsumoto, K. and Senda, M.,Development of a GSO positron/single-photon imaging detector, Phys. Med. Biol., 51: 457–469, 2006.

    Article  PubMed  CAS  Google Scholar 

  20. Gies, M., Kalender, W. A., Wolf, H., Suess, C. and Madsen, M. T.,Dose reduction in CT by anatomically adapted tube current modulation. I. Simulation studies, Med. Phys., 26: 2235–2247, 1999.

    Article  PubMed  CAS  Google Scholar 

  21. Kalender, W. A., Wolf, H. and Suess, C.,Dose reduction in CT by anatomically adapted tube current modulation. II. Phantom measurements, Med. Phys., 26: 2248–2253, 1999.

    Article  PubMed  CAS  Google Scholar 

  22. Kinahan, P. E., Hasegawa, B. H. and Beyer, T.,X-ray-based attenuation correction for positron emission tomography/computed tomography scanners, Semin. Nucl. Med., 33: 166–179, 2003.

    Article  PubMed  Google Scholar 

  23. Townsend, D. W., Carney, J. P. J., Yap, J. T. and Hall, N. C.,PET/CT today and tomorrow, J. Nucl. Med. (suppl), 45: 4S-14S, 2004.

    Google Scholar 

  24. Beyer, T., Antoch, G., Muller, S., Egelhof, T., Freudenberg, L. S., Debatin, J. and Bockisch, A.,Acquisition protocol considerations for combined PET/CT imaging, J. Nucl. Med. (suppl), 45: 24S-35S, 2004.

    Google Scholar 

  25. Alessio, A. M., Kinahan, P. E., Cheng, P. M., Vesselle, H. and Karp, J. S.,PET/CT scanner instrumentation, challenges and solutions, Radiologic Clinics of North America, 42: 1017–1032, 2004.

    Article  PubMed  Google Scholar 

  26. Accorsi, R., Adam, L.-E., Werner, M. E. and Karp, J. S.,Optimisation of a fully 3D single scatter simulation algorithm for 3D PET, Phys. Med. Biol., 49: 2577–2598, 2004.

    Article  PubMed  Google Scholar 

  27. Cheng, C.-C., Rahmim, A., Blinder, A., Camborde, M.-L., Raywood, K. and Sossi, V.,A scatter-corrected list-mode reconstruction and a practical scatter/random approximation technique for dynamic PET imaging, Phys. Med. Biol., 52: 2089–2106, 2007.

    Article  PubMed  Google Scholar 

  28. Markiewicz, P. J., Tamal, M., Julyan, P. J., Hastings, D. L. and Reader, A. J.,High Accuracy Multiple Scatter Modelling for 3D Whole Body PET, Phys. Med. Biol., 52: 829–247, 2007.

    Article  PubMed  CAS  Google Scholar 

  29. Ollinger, J. M.,Model-based scatter correction for fully 3D PET, Phys. Med. Biol., 41: 153–176, 1996.

    Article  PubMed  CAS  Google Scholar 

  30. Goerres, G. W., Hany, T. F., Kamel, E., von Schulthess, G. K. and Buck, A.,Head and neck imaging with PET and PET/CT: artefacts from dental metallic implants, Eur. J. Nuc. Med. Mol. Imag., 29: 367–370, 2002.

    Article  CAS  Google Scholar 

  31. Cook, G. J. R., Wegner, E. A. and Fogelman, I.,Pitfalls and Artifacts in 18FDG PET and PET/CT Oncologic Imaging, Semin. Nucl. Med., 34: 122–133, 2004.

    Article  PubMed  Google Scholar 

  32. Hamill, J. J., Brunken, R. C., Bybel, B., DiFilippo, F. P. and Faul, D. D.,A knowledge-based method for reducing attenuation artefacts caused by cardiac appliances in myocardial PET/CT, Phys. Med. Biol., 51: 2901–2918, 2006.

    Article  PubMed  Google Scholar 

  33. Williamson, J. F., Whiting, B. R., Benac, J., Murphy, R. J., Blaine, G. J., O’Sullivan, A., Politte, D. G. and Snyder, D. L.,Prospects for quantitative computed tomography imaging in the presence of foreign metal bodies using statistical image reconstruction, Med. Phys., 29: 2404–18, 2002.

    Article  PubMed  Google Scholar 

  34. Carney, J. P., Beyer, T., Brasse, D., Yap, J. T. and Townsend, D. W.,Clinical PET/CT scanning using oral CT contrast Agents, J. Nucl. Med. [abstract], 43: 57P, 2002.

  35. Nehmeh, S. A., Erdi, Y. E., Kalaigian, H., Kolbert, K. S., Pan, T., Yeung, H., Squire, O., Sinha, A., Larson, S. M. and Humm, J. L.,Correction for Oral Contrast Artifcats in CT Attenuation-Corrected PET Imagins Obtained by Combined PET/CT, J. Nucl. Med., 44: 1940–1944, 2003.

    PubMed  Google Scholar 

  36. Antoch, G., Kuehl, H., Kanja, J., Lauenstein, T. C., Schneermann, H., Hauth, E., Jentzen, W., Beyer, T., Goehde, S. C. and Debatin, J. F.,Dual-Modality PET/CT Scanning with Negative Oral Contrast Agent to Avoid Artifacts: Introduction and Evaulation, Radiology, 230: 879–885, 2004.

    Article  PubMed  Google Scholar 

  37. 37.Yau, Y.-Y., Chan, W.-Z., Tam, Y.-M., Vernon, P., Wong, S., Coel, M. and Kwok-Fai Chu, S.,Application of Intravenous Contrast in PET/CT: Does It Really Introduce Significant Attenuation Correction Error?, J. Nucl. Med., 46: 283–291, 2005.

    PubMed  Google Scholar 

  38. Berthelsen, A. K., Holm, S., Klausen, T. L., Andersen, F. and Hojgaard, L.,PET/CT with intravenous contrast can be used for PET attenuation correction in cancer patients, Eur. J. Nucl. Med. Mol. Imag., 32: 1167–1175, 2005.

    Article  CAS  Google Scholar 

  39. Schoder, H., Erdi, Y. E., Larson, S. M. and Yeung, H. W. D.,PET/CT: a new imaging technology in nuclear medicine, Eur. J. Nucl. Med. Mol. Imag., 30: 1419–1437, 2003.

    Article  Google Scholar 

  40. Beyer, T., Bockisch, A., Kuhl, H. and Martinez, M.-J.,Whole-Body 18F-FDG PET/CT in the Presence of Truncation Artifacts, J. Nucl. Med., 47: 91–99, 2006.

    PubMed  Google Scholar 

  41. Gambir, S. S., Czernin, J., Schimmer, J., Silverman, D., Coleman, R. E. and Phelps, M. E.,A Tabulated Summary of the FDG PET Literature, J. Nucl. Med. (suppl), 42: 1S-93S, 2001.

    Google Scholar 

  42. Czernin, J., Allen-Auerbach, M. and Schelbert, H. R.,Improvements in Cancer Staging with PET/CT: Literature-based evidence as of Septebmer 2006, J. Nucl. Med., 48: 78S-88S, 2007.

    PubMed  CAS  Google Scholar 

  43. Lardinois, D., Weder, W., Hany, T. F., Kamel, E. M., Korom, S., Seifert, B., von Schulthess, G. K. and Steinert, H. C.,Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography, N. Engl. J. Med., 348: 2500–2507, 2003.

    Article  PubMed  Google Scholar 

  44. Bar-Shalom, R., Yefremov, N., Guralnik, L., Gaitini, D., Frenkel, A., Kuten, A., Altman, H., Keidar, Z. and Israel, O.,Clincal Performance on PET/CT in Evaluation of Cancer: Additional Value for Diagnostic Imaging and Patient Management, J. Nucl. Med., 44: 1200–1200, 2003.

    PubMed  Google Scholar 

  45. Antoch, G., Stattaus, J., Nemat, A. T., Marnitz, S., Beyer, T., Kuehl, H., Bocklsch, A., Debatin, J. F. and Freudenberg, L. S.,Non-small Cell Lung Cancer: Dual Modality PET/CT in Preoperative Staging, Radiol, 229: 526, 2003.

    Article  Google Scholar 

  46. Keidar, Z., Haim, N., Guralnik, L., Wollner, M., Bar-Shalom, R., Ben-Nun, A. and Israel, O.,PET/CT using 18F-FDG in Suspected Lung Cancer Recurrence: Diagnostic Value and Impact on Patient Management, J. Nucl. Med., 45: 1640, 2004.

    PubMed  Google Scholar 

  47. Wamena, B. A., Sonnad, S. S., Angobaldo, J. O. and Wahl, R. L.,Metastases from non-small cell lung cancer: mediastinal staging in the 1990s — meta-analytic comparison of PET and CT, Radiol., 213: 530–536, 1999.

    Google Scholar 

  48. Kalff, V., Hicks, R. J., MacManus, M. P.,Binns, D. S., McKenzie, A. F., Ware, R. E. H., A. and Ball, D. L.,Clinical impact of (18)F fluorodeoxyglucose positron emission tomography in patients with non-small-cell lung cancer: a prospective study, J. Clin. Oncol., 19: 111–118, 2007.

    Google Scholar 

  49. Malamitsi, J., Valotassiou, B., Iliadis, K., Kosmidis, P., Paspas, F., Vasilaki, M., Pipini, E., Petounis, A., Gogou, L., Pagou, M., Dalianis, K., Efthimiadou, R. and Andreou, J.,Preliminary Results on The Role of PET/CT in Initial Staging, Restaging and Management of Lung Cancer, Nucl. Instr. Meth. Phys. Res, 569: 319–322, 2006.

    Article  CAS  Google Scholar 

  50. Fischer, B. M., Mortensen, J., Langer, S. W., Loft, A., Berthelsen, A. K., Daugaard, G., Lassen, U. and Hansen, H. H.,PET/CT imaging in response evaluation of patients with small cell lung cancer, Lung Cancer, 54: 41–49, 2006.

    Article  PubMed  Google Scholar 

  51. Schoder, H., Yeung, H. W. D., Gonen, M., Kraus, D. and Larson, S. M.,Head and neck cancer: clinical usefulness and accuracy of PET/CT image fusion, Radiol., 231:65–722, 2004.

    Article  Google Scholar 

  52. Yau, Y.-Y., Samman, N. and Yeung, R. W. K.,Positron emission tomography/computed tomography true fusion imaging in clinical head and neck oncology: Early experience, J. Oral. Maxillofac. Surg., 63: 479–486, 2005.

    Article  PubMed  Google Scholar 

  53. Zimmer, L. A., McCook, B., Melter, C., Fukui, M., Bascom, D., Synderman, C., Townsend, D. W. and Johnson, J. T.,Combined positron emission tomography/computed tomography imaging of recurrent thyroid cancer, Otolaryngology — Head and Neck Surgery, 128: 178–184, 2003.

    Article  PubMed  Google Scholar 

  54. Schoder, H., Carlson, D. L., Kraus, D. H., Stambuk, H. E., Gonen, M., Erdi, Y. E., Yeung, H. W. D., Huvos, A. G., Shah, J. P., Larson, S. M. and Wong, R. J.,18F-FDG PET/CT for detecting nodal metastases in patients with oral cancer staged N0 by clinical examination and CT/MRI, J. Nucl. Med., 47: 755–762, 2006.

    PubMed  Google Scholar 

  55. Schwartz, D. L., Ford, E., Rajendran, J., Yueh, B., Coltera, M. D., Virgin, J., Anzai, Y., Haynor, D., Lewellyn, B., Mattes, D., Meyer, J. and Phillips, M.,FDG-PET CT imaging for preradiotherapy staging of head-and-neck squamous cell carcinoma, Int. J. Radiat. Oncol. Biol. Phys., 61: 129–136, 2005.

    PubMed  Google Scholar 

  56. Goerres, G. W., von Schulthess, G. K. and Steinert, H. C.,Why most PET of lung and head-and-neck cancer will be PET/CT, J. Nucl. Med. (suppl), 45: 66S-71S, 2004.

    Google Scholar 

  57. Fukui, M. B., Blodgett, T. M. and Meltzer, C. C.,PET/CT imaging in recurrent head and neck cancer, Semin. Ultrasound CT MRI, 24: 157–163, 2003.

    Article  Google Scholar 

  58. Connell, C. A., Corry, J., Milner, A. D., Hogg, A., Hicks, R. J., Rischin, D. and Peters, L. J.,Clinical impact of, and prognostic stratification by, F-18 FDG PET/CT in head and neck mucosal squamous cell carcinoma, Head & Neck, 29: 986–995, 2007.

    Article  Google Scholar 

  59. Rosenbaum, S. J., Stergar, H., Antoch, G., Veit, P., Bockisch, A. and Kühl, H.,Staging and follow-up of gastrointestinal tumours with PET/CT, Abdom. Imaging, 31: 23–35, 2005.

    Google Scholar 

  60. Schoder, H., Larson, S. M. and Yeung, H. W. D.,PET/CT in oncology: integration into clinical management of lymphoma, melanoma, and gastrointestinal malignancies, J. Nucl. Med. (suppl), 45: 72S-81S, 2004.

    Google Scholar 

  61. Wechalekar, K., Sharma, B. and Cook, G.,PET/CT in Oncology — A Major Advance, Clin. Radiol., 60: 1143–1155, 2005.

    Article  PubMed  CAS  Google Scholar 

  62. Antoch, G., Kanja, J., Bauer, S., Kuehl, H., Renzing-Koehler, K., Schuette, J., Bockisch, A., Debatin, J. F. and Freudenberg, L. S.,Comparison of PET, CT, and dual-modality PET/CT imaging for monitoring of imatinib (STI571) therapy in patients with gastrointestinal stromal tumors, J. Nucl. Med., 45: 357–365, 2004.

    PubMed  CAS  Google Scholar 

  63. Goerres, G. W., Stupp, R., Barghouth, G., Hany, T. F., Pestalozzi, B., Dizendorf, E., Schnyder, P., Luthi, F., von Schulthess, G. K. and Leyvraz, S.,The value of PET, CT and in-line PET/CT in patients with gastrointestinal stromal tumours: long-term outcome of treatment with imatinib mesylate, Eur. J. Nuc. Med. Mol. Imag., 32: 153–162, 2005.

    Article  CAS  Google Scholar 

  64. Cohade, C., Osman, M., Leal, J. and Wahl, R. L.,Direct Comparison of 18F-FDG PET and PET/CT in Patients with Colorectal Carcinoma, J. Nucl. Med., 44: 1797, 2003.

    PubMed  Google Scholar 

  65. Even-Sapir, E., Parag, Y., Lerman, H., Gutman, M., Levine, C., Rabau, M., Figer, A. and Metser, U.,Detection of Recurrence in Patients with Rectal Cancer: PET/CT After Abdominoperineal or Anterior Resection, Radiol., 232: 815–822, 2004.

    Article  Google Scholar 

  66. Cohn, D. E., Dehdashti, F., Gibb, R. K., Mutch, D. G., Rader, J. S., Siegel, B. A. and Herzog, T. J.,Prospective Evaluation of Positron Emission Tomography for the Detection of Groin Node Metastases from Vulvar Cancer, Gynecol. Onc., 85: 179–184, 2002.

    Article  Google Scholar 

  67. Nakamoto, Y., Eisbruch, A., Achtyes, E. D., Sugawara, Y., Reynolds, K. R., Johnston, C. M. and Wahl, R. L.,Prognostic Value of Positron Emission Tomography Using F-18-Fluorodeoxyglucose in Patients with Cervical Cancer Undergoing Radiotherapy, Gynecol. Onc., 84: 289–295, 2002.

    Article  Google Scholar 

  68. Horowitz, N. S., Dehdashti, F., Herzog, T. J., Rader, J. S., Powell, M. A., Gibb, R. K., Grigsby, P. W., Siegel, B. A. and Mutch, D. G.,Prospective evaluation of FDG-PET for detecting pelvic and para-aortic lymph node metastasis in uterine corpus cancer, Gynecol. Onc., 95: 546–551, 2004.

    Article  Google Scholar 

  69. Lamoreaux, W. T., Grigsby, P. W., Dehdashti, F., Zoberi, I., Powell, M. A., Gibb, R. K., Rader, J. S., Mutch, D. G. and Siegel, B. A.,FDG-PET evaluation of vaginal carcinoma, Int. J. Radiat. Oncol. Brit., 62: 733–737, 2005.

    Article  Google Scholar 

  70. Makhija, S., Howden, N., Edwards, R., Kelley, J., Townsend, D. W. and Meltzer, C. C.,Positron emission tomography/computed tomography imaging for the detection of recurrent ovarian and fallopian tube carcinoma: a retrospective review, Gynecol. Onc., 85: 53–58, 2002.

    Article  CAS  Google Scholar 

  71. Grisaru, D., Almog, B., Levine, C., Metser, U., Fishman, A., Lerman, H., Lessing, J. B. and Even-Sapir, E.,The diagnostic accuracy of 18F-fluorodeoxyglucose PET/CT in patients with gynaecological malignancies, Gynecol. Onc., 94: 680–684, 2004.

    Article  Google Scholar 

  72. Wahl, R.,Why nearly all PET of abdominal and pelvic cancers will be performed as PET/CT, J. Nucl. Med. (suppl), 45: 82S-95S, 2004.

    Google Scholar 

  73. Simcock, B., Neesham, D., Quinn, M., Drummond, E., Milner, A. and Hicks, R. J.,The impact of PET/CT in the management of recurrent ovarian cancer, Gynecol. Onc., 103:271–2766, 2006.

    Article  Google Scholar 

  74. Zangheri, B., Messa, C., Picchio, M., Gianolli, L., Landoni, C. and Fazio, F.,PET/CT and breast cancer, Eur. J. Nucl. Med. Mol. Imag. (suppl), 31: S135-S142, 2004.

    Article  Google Scholar 

  75. Tatsumi, M., Cohade, C., Mourtzikos, K., Fishman, E. K. and Wahl, R.,Initial experience with FDG PET/CT in the evaluation of breast cancer, Eur. J. Nucl. Med. Mol. Imag., 33: 254–262, 2006.

    Article  Google Scholar 

  76. Du, Y., Cullum, I., Illidge, T. M. and Ell, P. J.,Fusion of metabolic function and morphology: sequential [18F]fluorodeoxyglucose positron-emission tomography/computed tomography studies yield new insights into the natural history of bone metastases in breast cancer, J. Clin. Oncol., 25: 3440–3447, 2007.

    Article  PubMed  Google Scholar 

  77. Cachin, F., Prince, H. M., Hogg, A., Ware, R. E. and Hicks, R. J.,Powerful prognostic stratification by [18F]fluorodeoxyglucose positron emission tomography in patients with metastatic breast cancer treated with high-dose chemotherapy, J. Clin. Oncol., 24: 3026–3031, 2006.

    Article  PubMed  Google Scholar 

  78. Radan, L., Ben-Haim, S., Bar-Shalom, R., Guralnik, L. and Israel, O.,The role of FDG-PET/CT in suspected recurrence of breast cancer, Cancer, 107: 2545–2551, 2006.

    Article  PubMed  Google Scholar 

  79. Picchio, M., Messa, C., Landoni, C., Gianolli, L., Sironi, S. and Brioschi, M.,Value of [11C] Choline Positron Emission Tomography for Re-Staging Prostate Cancer: A Comparison with [18F] Fluorodeoxyglucose-Positron Emission Tomography, J. Urol., 169: 1337–1340, 2003.

    Article  PubMed  CAS  Google Scholar 

  80. Reske, S. N., Blumstein, N. M., Neumaier, B., Gottfried, H. W., Finsterbusch, F., Kocot, D., Möller, P., Glatting, G. and Perner, S.,Imaging Prostate Cancer with 11C-Choline PET/CT, J. Nucl. Med., 47: 1249–1254, 2006.

    PubMed  CAS  Google Scholar 

  81. Kwee, S. A., Wei, H., Sesterhenn, I., Yun, D. and Coel, M. N.,Localization of Primary Prostate Cancer with Dual-Phase 18F-fluorocholine PET, J. Nucl. Med., 47:262–2699, 2006.

    PubMed  Google Scholar 

  82. Segall, G. M.,FDG PET Imaging in Patients with Lymphoma: A Clinical Perspective, J. Nucl. Med., 42: 609–610, 2001.

    PubMed  CAS  Google Scholar 

  83. Hany, T. F., Steinert, H. C., Goerres, G. W., Buck, A. and von Schulthess, G. K.,PET Diagnostic Accuracy: Improvement with In-Line PET-CT System: Initial Results, Radiol., 225: 575–581, 2002.

    Article  Google Scholar 

  84. Israel, O., Mor, M., Gaitini, D., Keidar, Z., Guralnik, L., Engel, A., Frenkel, A., Bar-Shalom, R. and Kuten, A.,Combined Functional and Structural Evaluation of Cancer Patients with a Hybrid Camera-Based PET/CT System Using 18F-FDG, J. Nucl. Med., 43: 1129–1136, 2002.

    PubMed  Google Scholar 

  85. Charron, M., Beyer, T., Bohnen, N. N., Kinahan, P. E., Dachille, M., Jerin, J., Nutt, R., Meltzer, C. C., Villemagne, V. L. and Townsend, D. W.,Image analysis in oncology patients studied with a combined PET/CT scanner, Clin. Nucl. Med., 25: 905–910, 2000.

    Article  PubMed  CAS  Google Scholar 

  86. Tatsumi, M., Cohade, C., Nakamoto, Y., Fishman, E. K. and Wahl, R. L.,Direct Comparison of FDG PET and CT Findings in Patients with Lymphoma: Initial Experience, Radiol., 237: 1038–1045, 2005.

    Article  Google Scholar 

  87. Rodriguez, V. B., Gomez, L. N., Pinilla, I., Hernandez, M. D., Coya, J. and Martin, C. L.,Positron emission tomography/computed tomography in the management of Hodgkin’s disease and non-Hodgkin’s lymphoma, Curr. Probl. Diagn. Radiol., 35: 151–63, 2006.

    Article  Google Scholar 

  88. Schaefer, N. G., Hany, T. F., Taverna, C., Seifert, B., Stumpe, K. D. M., von Schulthess, G. K. and Goerres, G. W.,Non-Hodgkin Lymphoma and Hodgkin Disease: Coregistered FDG PET and CT at Staging and Restaging-Do We Need Contrast-enhanced CT?, Radiol., 232: 823–829, 2004.

    Article  Google Scholar 

  89. Freudenberg, L. S., Antoch, G., Schutt, P., Beyer, T., Jentzen, W., Muller, S. P., Gorges, R., Nowrousian, M. R., Bockisch, A. and Debatin, J. F.,FDG-PET/CT in re-staging of patients with lymphoma, Eur. J. Nucl. Med. Mol. Imag., 31: 325–329, 2004.

    Article  CAS  Google Scholar 

  90. Metser, U., Lerman, H., Blank, A., Lievshitz, G., Bokstein, F. and Even-Sapir, E.,Malignant Involvement in the Spine: Assessment by 18F-FDG PET/CT, J. Nucl. Med., 45: 279–284, 2004.

    PubMed  Google Scholar 

  91. Gutzeit, A., Antoch, G., Kühl, H., Egelhof, T., Fischer, M., Hauth, E., Goehde, S., Bockisch, A., Debatin, J. and Freudenberg, L.,Unknown Primary Tumours: Detection with Dual-Modality PET/CT — Initial Experience, Radiol., 234: 227–234, 2005.

    Article  Google Scholar 

  92. Israel, O., Mor, M., Guralnik, L., Hermoni, N., Gaitini, D., Bar-Shalom, R., Keidar, Z. and Epelbaum, R.,Is 18F-FDG PET/CT Useful for Imaging and Management of Patients with Suspected Occult Recurrence of Cancer, J. Nucl. Med., 45: 2045–2051, 2004.

    PubMed  Google Scholar 

  93. King, G.,PET-CT alters management of patients with gynecologic cancers, ASCO Proc., May 18–21, Orlando, Florida, 2002.

  94. Mac Manus, M., Hicks, R. J. and Everitt, S.,Role of PET-CT in the optimization of thoracic radiotherapy, J. Thorac. Oncol., 1: 81–84, 2006.

    Article  PubMed  Google Scholar 

  95. Hicks, R. J. and Mac Manus, M. P.,18F-FDG PET in candidates for radiation therapy: is it important and how do we validate its impact?, J. Nucl. Med., 44: 2003.

  96. Ciernik, I. F., Dizendorf, E., Baumert, B. G., Reiner, B., Burger, C., Davis, J. B., Lutolf, U. M., Steinert, H. C. and von Schulthess, G. K.,Radiation Treatment Planning with An Integrated Positron Emission and Computer Tomography (PET/CT): A Feasibility Study, Int. J. Radiat. Oncol. Biol. Phys., 57: 853–863, 2003.

    PubMed  Google Scholar 

  97. Paulino, A. C., Koshy, M., Howell, R., Schuster, D. and Davis, L. W.,Comparison of CT- and FDG-PET-Defined Gross Tumor Volume in Intensity-Modulated Radiotherapy for Head-and-Neck Cancer, Int. J. Radiat. Oncol. Biol. Phys., 61: 1385–1392, 2005.

    PubMed  Google Scholar 

  98. Ashamalla, H., Rafla, S., Parikh, K., Mokhtar, B., Goswani, G., Kambam, S., Abdel-Dayem, H., Guirguis, A., Ross, P. and Evola, A.,The contribution of integrated PET/CT to the evolving definition of treatment volumes in radiation treatment planning in lung cancer, Int. J. Radiat. Oncol. Biol. Phys., 63: 1016–1023, 2005.

    PubMed  Google Scholar 

  99. Ashamalla, H., Guirguis, A., Bieniek, E., Rafla, S., Evola, A., Goswami, G., Oldroyd, R., Mokhtar, B. and Parikh, K.,The Impact of Positron Emission Tomography/Computed Tomography in Edge Delineation of Gross Tumor Volume for Head and Neck Cancers, Int. J. Radiat. Oncol. Biol. Phys., 68: 388–395, 2007.

    PubMed  Google Scholar 

  100. Gondi, V., Bradley, K., Mehta, M., Howard, A., Khuntia, D., Ritter, M. and Tomé, W.,Impact of Hybrid Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography on Radiotherapy Planning in Esophageal and Non-Small Cell Lung Cancer, Int. J. Radiat. Oncol. Biol. Phys., 67: 187–195, 2007.

    PubMed  Google Scholar 

  101. Heron, D. E., Andrade, R. S., Flickinger, J., Johnson, J., Agarwala, S. S., Wu, A., Kalnicki, S. and Avril, N.,Hybrid PET-CT Simulation for Radiation Treatment Planning in Head and Neck Cancers: A Brief Technical Report, Int. J. Radiat. Oncol. Biol. Phys., 60: 1419–1424, 2004.

    PubMed  Google Scholar 

  102. Wang, D., Schultz, C. J., Jursinic, P. A., Bialkowski, M., Zhu, X. R., Brown, W. D., Rand, S. D., Michel, M. A., Campbell, B. H., Wong, S., Li, X. A. and Wilson, F. W.,Initial Experience of FDG-PET/CT Guided IMRT of Head-and-Neck Carcinoma, Int. J. Radiat. Oncol. Biol. Phys., 65: 143–151, 2006.

    PubMed  Google Scholar 

  103. Bradley, J., Thorstad, W. L., Mutic, S., Miller, T. R., Dehdashti, F., Siegel, B. A., Bosch, W. and Bertrand, R. J.,Impact of FDG-PET on Radiation Therapy Volume Delineation in Non-Small-Cell Lung Cancer, Int. J. Radiat. Oncol. Biol. Phys, 59: 78–86, 2004.

    PubMed  Google Scholar 

  104. Biehl, K. J., Kong, F.-M., Dehdashti, F., Jin, J.-Y., Mutic, S., El Naqa, I., Siegel, B. A. and Bradley, J. D.,18F-FDG PET Definition of Gross Tumor Volume for Radiotherapy of Non-Small Cell Lung Cancer: Is a Single Standardized Uptake Value Threshold Approach Appropriate?, J. Nucl. Med., 47: 1808–1812, 2006.

    PubMed  Google Scholar 

  105. Nestle, U., Kremp, S. and Grosu, A.-L.,Practical integration of [18F]-FDG-PET and PET-CT in the planning of radiotherapy for non-small cell lung cancer (NSCLC): The technical basis, ICRU-target volumes, problems, perspectives, Rad. Onc., 81: 209–225, 2006.

    Article  CAS  Google Scholar 

  106. Grégoire, V., Haustermans, K., Geets, X., Roels, S. and Lonneux, M.,PET-Based Treatment Planning in Radiotherapy: A New Standard?, J. Nucl. Med. (suppl), 48: 68S-77S, 2007.

    Google Scholar 

  107. Riegel, A. C., Berson, A. M., Destian, S., Ng, T., Tena, L. B., Mitnick, R. J. and Wong, P. S.,Variability of gross tumour volume delineation in head-and-neck cancer using CT and PET/CT, Int. J. Radiat. Oncol. Biol. Phys, 65: 726–32, 2006.

    PubMed  Google Scholar 

  108. Ling, C. C., Humm, J., Larson, S., Amols, H., Fuks, Z., Leibel, S. and Koutcher, J. A.,Towards multidimensional radiotherapy (MD-CRT): Biological Imaging and Biological Conformity, Int. J. Radiat. Oncol. Biol. Phys., 47: 551–560, 2000.

    Article  PubMed  CAS  Google Scholar 

  109. Søvik, A., Malinen, E., Skogmo, H. K., Bentzen, S. M., Bruland, O. S. and Olsen, D. R.,Radiotherapy Adapted to Spatial and Temporal Variability in Tumor Hypoxia, Int. J. Radiat. Oncol. Biol. Phys., 68: 1496–1504, 2007.

    PubMed  Google Scholar 

  110. Vanderstraeten, B., Duthoy, W., De Gersem, W., De Neve, W. and Thierens, H.,[18F] fluoro-deoxy-glucose positron emission tomography ([18F]FDG-PET) voxel intensity-based intensity-modulated radiation therapy (IMRT) for head and neck cancer, Rad. Onc., 79: 249–258, 2006.

    Article  CAS  Google Scholar 

  111. Ell, P. J.,The contribution of PET/CT to improved patient Management, BJR., 79: 32–26, 2006.

    Article  PubMed  CAS  Google Scholar 

  112. 112. von Schulthess, G. K., Steinert, H. C. and Hany, T. F.,Integrated PET/CT: Current applications and future Directions, Radiobiology, 238: 405–422, 2006.

    Google Scholar 

  113. Kapuco, L. O., Meltzer, C. C., Townsend, D. W., Keenan, R. J., and Luketich, J.D.,Fluorine-18-fluorodeoxyglucose uptake in pneumonia, J. Nucl. Med., 39: 1267–1269, 1998.

    Google Scholar 

  114. Bakheet, S. M., Powe, J., Ezzat, A. and Roston, A.,F-18-FDG uptake in tuberculosis, Clin. Nucl. Med., 23: 739–742, 1998.

    Article  PubMed  CAS  Google Scholar 

  115. Bakheet, S. M., Powe, J., Kandil, A., Ezzat, A., Rostom, A. and Amartey, J.,F-18-FDG uptake in breast infection and inflammation, Clin. Nucl. Med., 25: 100–103, 2000.

    Article  PubMed  CAS  Google Scholar 

  116. Gysen, M., Stroobants, S. and Mortelmans, L.,Proliferative myositis: a case of a pseudomalignant process, Clin. Nucl. Med., 23: 836–838, 1998.

    Article  PubMed  CAS  Google Scholar 

  117. Yasuda, S., Shohtsu, A., Ide, M., Takagi, S., Kijima, H. and Horiuchi, M.,Elevated F-18 FDG uptake in plasmacyte-rich chronic maxillary sinusitis, Clin. Nucl. Med., 23: 176–178, 1998.

    Article  PubMed  CAS  Google Scholar 

  118. Brudin, L. H., Valind, S.-O., Rhodes, C. G., Panting, C. F., Sweatmang, M., Jones, T. and Hughes, J. M. B.,Fluorine-18 deoxyglucose uptake in sarcoidosis measured with positron emission tomography, Eur. J. Nucl. Med. Mol. Imag., 21: 297–305, 1994.

    Article  CAS  Google Scholar 

  119. Tahara, T., Ichiya, Y., Kuwabara, Y., Otsuka, M., Miyake, Y., Gunasekera, R. and Masuda, K.,High [18F]-fluorodeoxyglucose uptake in abdominal abscesses: a PET study, J. Comput. Assist. Tomogr., 13: 829–831, 1989.

    Article  PubMed  CAS  Google Scholar 

  120. Crymes, W. B., Demos, H. and Gordon, L.,Detection of musculoskeletal infection with 18F-FDG PET: Review of the current literature, J. Nucl. Med. Technol., 32: 12–15, 2004.

    PubMed  Google Scholar 

  121. Stumpe, K. D. M. and Strobel, K.,18F FDG PET imaging in musculoskeletal infection, Q. J. Nucl. Med. Mol. Imaging., 50: 131–142, 2006.

    PubMed  CAS  Google Scholar 

  122. Keidar, Z., Militianu, D., Melamed, E., Bar-Shalom, R. and Israel, O.,The diabetic foot: initial experience with 18F-FDG PET/CT, J. Nucl. Med., 46: 444–449, 2005.

    PubMed  Google Scholar 

  123. Schiesser, M., Stumpe, K. D. M., Trentz, O., Kossmann, T., and Schulthess, v. G.K.,Detection of metallic implant-associated infections with FDG PET in patients with trauma: correlation with microbiologic results, Radiol., 226: 391–398, 2003.

    Article  Google Scholar 

  124. Meller, J., Sahlmann, C. O. and Scheel, A. K.,18F-FDG PET and PET/CT in fever of unknown origin, J. Nucl. Med., 48: 35–45, 2007.

    PubMed  CAS  Google Scholar 

  125. Kaufmann, P. A. and Camici, P. D.,Myocardial blood flow measurement by PET: Technical aspects and clinical applications, J. Nucl. Med., 46: 77–88, 2005.

    Google Scholar 

  126. Koepfli, P., Hany, T. F., Wyss, C. A., Namdar, M., Burger, C., Konstantinidis, A. V., Berthold, T., von Schulthess, G. K. and Kaufmann, P. A.,CT attenuation correction for myocardial perfusion quantification using a hybrid PET/CT scanner, J. Nucl. Med., 45: 537–542, 2004.

    PubMed  Google Scholar 

  127. Lodge, M. A., Braess, H., Mahmoud, F., Suh, J., Englar, N., Geyser-Stoops, S., Jenkins, J., Bacharach, S. L. and Dilsizian, V.,Review: Developments in nuclear cardiology: Transition from single photon emission computed tomography to positron emission tomography/computed tomography, J. Invasive Cardiol., 17: 491–496, 2005.

    PubMed  Google Scholar 

  128. Schwaiger, M., Ziegler, S. and Nekolla, S. G.,PET/CT: Challenge for nuclear cardiology, J. Nucl. Med., 46: 1664–1678, 2005.

    PubMed  Google Scholar 

  129. Tatsumi, M., Cohade, C., Nakamoto, Y. and Wahl, R. L.,Fluorodeoxyglucose uptake in the aortic wall at PET/CT: possible finding for active atherosclerosis, Radiol., 229: 831–839, 2003.

    Article  Google Scholar 

  130. Wagner, B., Anton, M., Nekolla, S. G., Reder, S., Henke, J., Seidl, S., Hegenloh, R., Miyagawa, M., Haubner, R., Schwaiger, M. and Bengel, F. M.,Noninvasive Characterization of Myocardial Molecular Interventions by Integrated Positron Emission Tomography and Computed Tomography, J. Am. Coll. Cardiol., 48: 2107–2115, 2006.

    Article  PubMed  Google Scholar 

  131. Townsend, D. W., Beyer, T. and Blodget, T. M.,PET/CT scanners: A hardware approach to image fusion, Semin. Nucl. Med., 33: 193–204, 2003.

    Article  PubMed  Google Scholar 

  132. Brianzoni, E., Rossi, G., Ancidei, S., Berbellini, A., Capoccetti, F., Cidda, C., D’Avenia, P., Fattori, S., Montini, G. C., Valentini, G. and Proietti, A.,Radiotherapy planning: PET/CT scanner performances in the definition of gross tumour volume and clinical target volume, Eur. J. Nucl. Med. Mol. Imag., 32: 1392–1399, 2005.

    Article  Google Scholar 

  133. Shim, S. S., Lee, K. S., Kim, B.-T., Chung, M. J., Lee, E. J., Han, J., Choi, J. Y., Kwon, O. J., Shim, Y. M. and Kim, S.,Non-Small Cell Lung Cancer: Prospective Comparison of Integrated FDG PET/CT and CT Alone for Preoperative Staging, Radiol., 236: 1011–1019, 2005.

    Article  Google Scholar 

  134. Kim, Y. K., Lee, K. S., Kim, B.-T., Choi, J. Y., Kim, H., Kwon, O. J., Shim, Y. M., Yi, C. A., Kim, H. Y. and Chung, M. J.,Mediastinal Nodal Staging of Nonsmall Cell Lung Cancer Using Integrated 18F-FDG PET/CT in a Tuberculosis-Endemic Country: Diagnostic Efficacy in 674 Patients, Cancer, 109: 1068–1077, 2007.

    Article  PubMed  Google Scholar 

  135. Ha, P. K., Hdeib, A., Goldenberg, D., Jacene, H., Patel, P., Koch, W., Califano, J., Cummings, C. W., Flint, P. W., Wahl, R. and Tufano, R. P.,The role of positron emission tomography and computed tomography fusion in the management of early-stage and advanced-stage primary head and neck squamous cell carcinoma, Arch. Otolaryngol. Head Neck Surg., 132: 12–16, 2006.

    Article  PubMed  Google Scholar 

  136. Breen, S. L., Publicover, J., De Silva, S., Pond, G., Brock, K., O’Sullivan, B., Cummings, B., Dawson, L., Keller, A., Kim, J., Ringash, J., Yu, E., Hendler, and Waldron, J.,Intraobserver and interobserver variability in GTV delineation on FDG-PET-CTimages of head and neck cancers, Int. J. Radiat. Oncol. Biol. Phys., in press.

  137. Murakami, R., Uozumi, H., Hirai, T., Nishimura, R., Shiraishi, S., Ota, K., Murakami, D., Tomiguchi, S., Oya, N., Katsuragawa, S. and Yamashita, Y.,Impact of FDG-PET/CT imaging on nodal staging for head-and-neck squamous cell carcinoma, Int. J. Radiat. Oncol. Biol. Phys., 68: 377–382, 2007.

    PubMed  Google Scholar 

  138. Israel, O., Yefremov, N., Bar-Shalom, R., Kagana, O., Frenkel, A., Keidar, Z. and Fischer, D.,PET/CT Detection of Unexpected Gastrointestinal Foci of 18F-FDG Uptake: Incidence, Localization Patterns, and Clinical Significance, J. Nucl. Med., 46: 758–762, 2005.

    PubMed  Google Scholar 

  139. Bar-Shalom, R., Guralnik, L., Tsalic, M., Leiderman, M., Frenkel, A., Gaitini, D., Ben-Nun, A., Keidar, Z. and Israel, O.,The additional value of PET/CT over PET in FDG imaging of oesophageal cancer, Eur. J. Nucl. Med. Mol. Imaging, 32: 918–924, 2005.

    Article  PubMed  Google Scholar 

  140. Kim, J.-H., Czernin, J., Allen-Auerbach, M. S., Halpern, B. S., Fueger, B. J., Hecht, J. R., Ratib, O., Phelps, M. E. and Weber, W. A.,Comparison between 18F-FDG PET, in-line PET/CT, and software fusion for restaging of recurrent colorectal cancer, J. Nucl. Med., 46: 587–595, 2005.

    PubMed  Google Scholar 

  141. Veit-Haibach, P., Kuehle, C. A., Beyer, T., Stergar, H., Kuehl, H., Schmidt, J., Borsch, G., Dahmen, G., Barkhausen, J., Bockisch, A. and Antoch, G.,Diagnostic Accuracy of Colorectal Cancer Staging With Whole-Body PET/CT Colonography, JAMA, 296: 2590–2600, 2006.

    Article  PubMed  CAS  Google Scholar 

  142. Choi, H. J., Roh, J. W., Seo, S.-S., Lee, S., Kim, J.-Y., Kim, S.-K., Kang, K. W., Lee, J. S., Jeong, J. Y. and Park, S.-Y.,Comparison of the Accuracy of Magnetic Resonance Imaging and Positron Emission Tomography/Computed Tomography in the Presurgical Detection of Lymph Node Metastases in Patients with Uterine Cervical Carcinoma, Cancer, Cancer, 106: 914–922, 2006.

    Google Scholar 

  143. Veit-Haibach, P., Antoch, G., Beyer, T., Stergar, H., Schleucher, R., Hauth, E. A. M. and Bockisch, A.,FDG-PET/CT in restaging of patients with recurrent breast cancer: possible impact on staging and therapy, BJR, 80: 508–515, 2007.

    Article  PubMed  CAS  Google Scholar 

  144. Piperkova, E., Raphael, B., Altinyay, M. E., Castellon, I., Libes, R., Sandella, N., Heiba, S. and Abdel-Dayem, H.,Impact of PET/CT in Comparison With Same Day Contrast Enhanced CT in Breast Cancer Management, Clin. Nucl. Med., 32: 429–434, 2007.

    Article  PubMed  Google Scholar 

  145. Schmid, D. T., John, H., Zweifel, R., Cservenyak, T., Westera, G., Goerres, G. W., von Schulthess, G. K. and Hany, T. F.,Fluorocholine PET/CT in patients with prostate cancer: initial experience, Radiol., 235: 623–628, 2005.

    Article  Google Scholar 

  146. Raanani, P., Shasha, Y., Perry, C., Metser, U., Naparstek, E., Apter, S., Nagler, A., Polliack, A., Ben-Bassat, I. and Even-Sapir, E.,Is CT scan still necessary for staging in Hodgkin and non-Hodgkin lymphoma patients in the PET/CT era?, Annals of Oncology, 17: 117–122, 2006.

    Article  PubMed  CAS  Google Scholar 

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Brady, Z., Taylor, M.L., Haynes, M. et al. The clinical application of PET/CT: a contemporary review. Australas. Phys. Eng. Sci. Med. 31, 90–109 (2008). https://doi.org/10.1007/BF03178584

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