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A Combined PET/CT Scanner for Clinical Oncology

PET Facility and Division of Nuclear Medicine, Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania
CTI PET Systems, Knoxville
Byars Consulting, Oak Ridge, Tennessee

Correspondence: For correspondence or reprints contact: David W. Townsend, PhD, PET Facility, Department of Radiology, University of Pittsburgh, 200 Lothrop St., Pittsburgh, PA 15213.

ABSTRACT

The availability of accurately aligned, whole-body anatomical (CT) and functional (PET) images could have a significant impact on diagnosing and staging malignant disease and on identifying and localizing metastases. Computer algorithms to align CT and PET images acquired on different scanners are generally successful for the brain, whereas image alignment in other regions of the body is more problematic. Methods: A combined PET/CT tomograph with the unique capability of acquiring accurately aligned functional and anatomical images for any part of the human body has been designed and built. The PET/CT scanner was developed as a combination of a Siemens Somatom AR.SP spiral CT and a partial-ring, rotating ECAT ART PET scanner. All components are mounted on a common rotational support within a single gantry. The PET and CT components can be operated either separately, or in combined mode. In combined mode, the CT images are used to correct the PET data for scatter and attenuation. Fully quantitative whole-body images are obtained for an axial extent of 100 cm in an imaging time of less than 1 h. When operated in PET mode alone, transmission scans are acquired with dual ¹³⁷Cs sources. Results: The scanner is fully operational and the combined device has been operated successfully in a clinical environment. Over 110 patients have been imaged, covering a range of different cancers, including lung, esophageal, head and neck, melanoma, lymphoma, pancreas, and renal cell. The aligned PET and CT images are used both for diagnosing and staging disease and for evaluating response to therapy. We report the first performance measurements from the scanner and present some illustrative clinical studies acquired in cancer patients. Conclusion: A combined PET and CT scanner is a practical and effective approach to acquiring co-registered anatomical and functional images in a single scanning session.

Key Words: oncology • PET • CT • dual modality • image fusion

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				O. Israel, M. Mor, L. Guralnik, N. Hermoni, D. Gaitini, R. Bar-Shalom, Z. Keidar, and R. Epelbaum Is 18F-FDG PET/CT Useful for Imaging and Management of Patients with Suspected Occult Recurrence of Cancer? J. Nucl. Med., December 1, 2004; 45(12): 2045 - 2051. [Abstract] [Full Text] [PDF]

				S. Sironi, C. Messa, G. Mangili, B. Zangheri, G. Aletti, E. Garavaglia, R. Vigano, M. Picchio, G. Taccagni, A. D. Maschio, et al. Integrated FDG PET/CT in Patients with Persistent Ovarian Cancer: Correlation with Histologic Findings Radiology, November 1, 2004; 233(2): 433 - 440. [Abstract] [Full Text] [PDF]

				J. A. Seibert X-Ray Imaging Physics for Nuclear Medicine Technologists. Part 1: Basic Principles of X-Ray Production J. Nucl. Med. Technol., September 1, 2004; 32(3): 139 - 147. [Abstract] [Full Text] [PDF]

				M. Horger, S. M. Eschmann, C. Pfannenberg, R. Vonthein, H. Besenfelder, C. D. Claussen, and R. Bares Evaluation of Combined Transmission and Emission Tomography for Classification of Skeletal Lesions Am. J. Roentgenol., September 1, 2004; 183(3): 655 - 661. [Abstract] [Full Text] [PDF]

				N. G. Schaefer, T. F. Hany, C. Taverna, B. Seifert, K. D. M. Stumpe, G. K. von Schulthess, and G. W. Goerres Non-Hodgkin Lymphoma and Hodgkin Disease: Coregistered FDG PET and CT at Staging and Restaging--Do We Need Contrast-enhanced CT? Radiology, September 1, 2004; 232(3): 823 - 829. [Abstract] [Full Text] [PDF]

				W. Romer, M. Chung, A. Chan, D. W. Townsend, F. Torok, B. McCook, M. P. Federle, and N. Avril Single-Detector Helical CT in PET-CT: Assessment of Image Quality Am. J. Roentgenol., June 1, 2004; 182(6): 1571 - 1577. [Abstract] [Full Text] [PDF]

				B. S. Halpern, M. Dahlbom, A. Quon, C. Schiepers, C. Waldherr, D. H. Silverman, O. Ratib, and J. Czernin Impact of Patient Weight and Emission Scan Duration on PET/CT Image Quality and Lesion Detectability J. Nucl. Med., May 1, 2004; 45(5): 797 - 801. [Abstract] [Full Text] [PDF]

				C. Lartizien, P. E. Kinahan, and C. Comtat A Lesion Detection Observer Study Comparing 2-Dimensional Versus Fully 3-Dimensional Whole-Body PET Imaging Protocols J. Nucl. Med., April 1, 2004; 45(4): 714 - 723. [Abstract] [Full Text] [PDF]

				H. Schoder, H. W. D. Yeung, M. Gonen, D. Kraus, and S. M. Larson Head and Neck Cancer: Clinical Usefulness and Accuracy of PET/CT Image Fusion Radiology, April 1, 2004; 231(1): 65 - 72. [Abstract] [Full Text] [PDF]

				G. Antoch, J. Kanja, S. Bauer, H. Kuehl, K. Renzing-Koehler, J. Schuette, A. Bockisch, J. F. Debatin, and L. S. Freudenberg 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., March 1, 2004; 45(3): 357 - 365. [Abstract] [Full Text]

				V. Kapoor, B. M. McCook, and F. S. Torok An Introduction to PET-CT Imaging RadioGraphics, March 1, 2004; 24(2): 523 - 543. [Abstract] [Full Text] [PDF]