Clinical Aspects of Positron Emission Tomography

Abstract

Positron emission tomography (PET) is a nuclear medicine technique that allows the in vivo regional quantitation of human biochemical and physiological processes. PET was originally developed and used for research purposes and only recently has it been used for clinical application.

Indeed, due to the interest of industry in this technology, largely automated instrumentation has recently become commercially available at an acceptable cost.

At the same time, following validation of a large number of subjects presenting with various pathologies, precise diagnostic protocols have been optimized.

The power of PET is in its unique ability to visualize biochemical processes. Its potential is highly enhanced when used in conjunction with other imaging techniques such as CT or MRI, in order to correlate morphology and function. The correlation with other techniques in the domain of electrophysiology, such as EEG and ECG, is also essential to understand the ralationship between these conventional physiological signals and the biochemical measurements obtained with PET.

The main features and applications of PET are reviewed in this paper, with particular emphasis on the diagnosis of coronary artery disease, cerebrovascular and cerbral degenerative disease, epilepsy, and tumors. Our experience on the organization of a clinical PET/Cyclotron center is also described. Given the incidence of the diseaseas that can be conveniently examined by PET, a population of approximately two million is the adequate basis for a PET center. The gain in terms of knowledge of precise biochemical process over a vast population can be seen as a long term investment for public health.