This chapter reviews PET/PET identification of metastatic disease, the main cause of cancer deaths. More than one‐third of newly diagnosed cancer patients have metastases detectable by PET/CT. There are three major pathways by which tumor cells disseminate: blood borne, lymphatic spread, and by seeding body cavities. The primary tumor location and histology in large part determines the most common route and frequency of metastasis. Increased FDG uptake in metastases permits identification on PET/CT. Cancer of unknown primary site is a relatively common clinical entity, resulting from a wide variety of primary sites. PET/CT identification of the primary tumor allows for focused therapy and potentially improved survival.
KeywordsLiver Metastasis Brain Metastasis Pulmonary Metastasis Adrenal Metastasis Adrenal Lesion
- Akeson P, Larsson EM, Kristoffersen DT (1995) Brain metastases–comparison of gadodiamide injection-enhanced MR imaging at standard and high dose, contrast-enhanced CT and non-contrast-enhanced MR imaging. Acta Radiol 36(3):300–6Google Scholar
- Even-Sapir E, Metser U, Mishani E, Lievshitz G, Lerman H, Leibovitch I (2006) The detection of bone metastases in patients with high-risk prostate cancer: 99mTc-MDP Planar bone scintigraphy, single- and multi-field-of-view SPECT, 18F-fluoride PET, and 18F-fluoride PET/CT. J Nucl Med 47:287–297PubMedGoogle Scholar
- Niekel MC, Bipat S, Stoker J (2010) Imaging for colorectal liver metastases-a meta-analysis. Ann Oncol 21(S1):37Google Scholar
- Salmon JM, Kilpatrick SE (2000) Pathology of skeletal metastases. Orthop Clin North Am 31:537–44, OctGoogle Scholar
- Wen PY, Loeffler JS (1999) Management of brain metastases. Oncology (Williston Park) Jul, 13(7):941–54, 957–61; discussion 961–2, 9Google Scholar