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Nuclear medicine fuses with radiology in joint session at ECR 2010 was organized by the European Association for Nuclear Medicine with the European Society of Radiology.

A special feature of the scientific program at ECR 10 was a joint session organized by the European Association for Nuclear Medicine with the European Society of Radiology. Two speakers representing the EANM took the podium to review developments in nuclear medicine and to challenge colleagues on specific applications.

Wolfgang Weber, MD, from the University of Freiburg spoke on the topic, “New probes to increase specificity and sensitivity of PET / CT in oncology.“

Demonstrated improvement in the specificity and sensitvity of PET begins, he said, with a well defined molecular target, depends upon identifying a specific ligand that can then be optimised to create an imaging probe.

After presenting a series of cases covering approaches now available including dose parameters, types of contrasts and across a series of conditions with issues affecting imaging for lymphoma, pancreatic and and breast cancers. He challenged where contrast-enhanced PET / CT is really needed and who in the medical chain of care is requesting such imaging.

For other tumor types, specifically colorectal cancers, ENT cancers and pancreatic cancers contrast-enhanced PET / CT is deterlined to be the modality of choice to deliver the answers needed by a surgeon.

The podium was then turned over to two speakers presenting topics on behalf of ESR .

Claire Smith, MD, from Mater Misericordiae University Hospital in Dublin, presented a sobering case reviewing the “Causes and imaging features of false positives/ false negatives on PET / CT in oncologic imaging.”

The uptake of fluoro-deoxy-glucose (FDG), the the most commonly used PET tracer for clinical molecular imaging in oncology is not reserved for tumors alone, being absorbed throughout the body.

Brown fat is classic study for radiologists and is seldom confused with malignancy, she said.

More challenging examples of false positives include flare phenomenon caused by FDG that hve led led to a recommendation for an unecessary cessation of therapy, as well as effects from other therapies, including dental work, that a patient may undergo separate from any oncological therapy.

Dr. Smith equally presented false-negatives, cases where PET / CT fails to identify malignant conditions, such as with carcinoid tumors that are PET -negative.

PET / CT presents a continuing challenge for interpreting radiologists, most especially in cases considered routine, she concluded, to distinguish cancer-specific indications for the range of benign conditions that can take up FDG and lead to mis-diagnosis overstating of disease and unnecessary biopsies.

The final speaker, Heiko Schöder, MD, from the Memorial Sloan-Kettering Cancer Center in New York offered a leading-edge view of an array of new tracers under investigation that replace FDG and more precisely target specific types of tumors.

Source: ECR

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