Study shows PET/CT imaging can help diagnose and define occult recurrent cancer

December 13, 2004

RESTON, Va.-- Combined positron emission tomography and computerized tomography (PET/CT) can help diagnose occult (hidden) recurrent cancer, possibly a cancer patient's greatest post-treatment fear, report a team of Israeli physicians in the December issue of the Society of Nuclear Medicine's "Journal of Nuclear Medicine."

PET and CT scans are standard imaging tools that allow clinicians to pinpoint the location of cancer within the body before making treatment recommendations. PET/CT involves sequential PET and CT imaging on the same device, allowing for simultaneous acquisition of functional (PET) and anatomical (CT) data. "PET/CT was found to indicate the presence of new malignancy and also precisely localize and define the extent of disease" in patients in whom recurring cancer was suspected, explained lead author and SNM member Ora Israel, M.D.

The physicians asked the question, "Is FDG-PET/CT Useful for Imaging and Management of Patients With Suspected Occult Recurrence of Cancer?" Their study points to an affirmative answer, said Israel, who also noted the need for these initial results to be confirmed in large studies with more homogenous patient populations. The research team studied 36 cancer patients for whom blood tests showed increasing levels of serum cancer markers during follow-up.

"PET/CT was the only test that showed whether recurrent tumors were indeed present," and since anatomic information was obtained, the type of treatment that should be applied could be determined, she said. "This is clinically important, since no treatment could be planned in these patients without the benefit of this combined test," added Israel, who is with the department of nuclear medicine at Rambam Medical Center and the B. Rappaport School of Medicine, Technion, Israel Institute of Technology, both in Haifa, Israel.

"If these results are confirmed by larger studies in patients with different types of malignant tumors, PET/CT may potentially be used in the future as the first imaging modality in this group of patients," Israel said. "In some of these patients, further invasive diagnostic procedures may not be needed, and the treating physicians may proceed directly with the appropriate treatment strategy," she added.

Israel noted that PET/CT is already playing a major role in a large variety of clinical indications in cancer patients. "The clinical dilemma of a suspicion of cancer raised by abnormal blood tests may be solved, and management of this patient group may be optimized by this imaging modality," said Israel. The study produced "important and very promising results," said Israel, "since they showed not only improved diagnostic accuracy of PET/CT over PET, as was initially hypothesized, but also the impact of patient management."
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"Is FDG-PET/CT Useful for Imaging and Management of Patients With Suspected Occult Recurrence of Cancer?" was written by Ora Israel, M.D., Department of Nuclear Medicine, Rambam Medical Center, and the B. Rappaport School of Medicine, Technion, Israel Institute of Technology, both in Haifa, Israel; Maya Mor, M.D., Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel; Luda Guralnik, M.D., Department of Diagnostic Imaging, Rambam Medical Center, Haifa, Israel; Nirit Hermoni, M.D., Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel; Diana Gaitini, M.D., the B. Rappaport School of Medicine, Technion, Israel Institute of Technology and the Department of Diagnostic Imaging, Rambam Medical Center, both in Haifa, Israel; Rachel Bar-Shalom, M.D., Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel; Zohar Keidar, M.D., Ph.D., Department of Nuclear Medicine, Rambam Medical Center, and the B. Rappaport School of Medicine, Technion, Israel Institute of Technology, both Haifa, Israel; and Ron Epelbaum, M.D., the B. Rappaport School of Medicine, Technion, Israel Institute of Technology, and the Department of Oncology, Rambam Medical Center, both in Haifa, Israel. Authors Israel, Bar-Shalom and Keidar are SNM members.

A copy of this article and related images is available to media representatives upon request to Maryann Verrillo (see contact information above). Current and past issues of "The Journal of Nuclear Medicine" can be found online at http://jnm.snmjournals.org. Print copies can be obtained at $20 per copy by contacting the SNM Service Center, Society of Nuclear Medicine, 1850 Samuel Morse Drive, Reston, VA 20190-5316; phone 703-326-1186; e-mail servicecenter@snm.org; fax 703-708-9015. A subscription to the journal is an SNM member benefit. Nonmember subscriptions are $210 for individuals and $318 for institutions.

The Society of Nuclear Medicine is an international scientific and professional organization of more than 15,000 members dedicated to promoting the science, technology and practical applications of nuclear medicine. The SNM is based in Reston, Va.; additional information can be found online at http://www.snm.org.

Society of Nuclear Medicine

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