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A positron emission tomography (PET) scan is an imaging test that helps reveal how

your tissues and organs are functioning. A PET scan uses a radioactive drug (tracer) to
show this activity.
The tracer may be injected, swallowed or inhaled, depending on which organ or tissue is
being studied by the PET scan. The tracer collects in areas of your body that have
higher levels of chemical activity, which often correspond to areas of disease. On a PET
scan, these areas show up as bright spots.
A PET scan is useful in revealing or evaluating several conditions, including some
cancers, heart disease and brain disorders.

Why its done

A PET scan is an effective way to examine the chemical activity in parts of your body. It
may help identify a variety of conditions, including some cancers, heart disease and
brain disorders. The pictures from a PET scan provide information different from that
uncovered by other types of scans, such as computerized tomography (CT) or magnetic
resonance imaging (MRI). A PET scan or a combined CT-PET scan enables your doctor
to better diagnose your condition.
Cancer
Cancer cells show up as bright spots on PET scans because they have a higher
metabolic rate than do normal cells. PET scans may be useful in:

Detecting cancer

Revealing whether your cancer has spread

Checking whether a cancer treatment is working

Finding a cancer recurrence

PET scans must be interpreted carefully because noncancerous conditions can look like
cancer, and many types of cancer do not appear on PET scans. The types of cancer
most likely to show up on PET scans include:

Brain

Breast

Cervical

Colorectal

Esophageal

Head and neck

Lung

Lymphoma

Melanoma

Pancreatic

Prostate

Thyroid

Heart disease
PET scans can reveal areas of decreased blood flow in the heart. This information can
help you and your doctor decide, for example, whether you might benefit from a
procedure to open clogged heart arteries (angioplasty) or coronary artery bypass
surgery.
Brain disorders
PET scans can be used to evaluate certain brain disorders, such as:

Tumors

Alzheimer's disease

Seizures

Risks

For your PET scan, a radioactive drug (tracer) will be put into your body. The amount of
radiation you're exposed to is small, and the risk of negative effects from it is low. But
the tracer might:

Cause a major allergic reaction, in rare instances

Expose your unborn baby to radiation if you are pregnant

Expose your child to radiation if you are breast-feeding

Talk with your doctor about the benefits and risks of a PET scan.

How you prepare

Tell your doctor:

If you've ever had a bad allergic reaction


If you've been sick recently or you have another medical condition, such as
diabetes

If you're taking any medications, vitamins or herbal supplements

If you're pregnant or think you might be pregnant

If you're breast-feeding

If you're afraid of enclosed spaces (claustrophobic)

Your doctor will give you detailed instructions on how to prepare for your scan. A general
rule is to avoid strenuous exercise for a couple of days before the study and to stop
eating a few hours before the scan.

What you can expect

The PET scanner is a large machine that looks a little like a giant doughnut standing
upright, similar to a computerized tomography (CT) machine. You'll need about two

hours for the procedure, which may be done on an outpatient basis (no overnight
hospital stay). When you arrive for your scan, you may be asked to:

Change into a hospital gown

Empty your bladder

Then you will be given a radioactive drug (tracer). You may receive the drug by injection
or be asked to inhale or swallow it, depending on the type of tracer being used. If the
drug is injected, you may briefly feel a cold sensation moving up your arm. You'll need to
wait 30 to 60 minutes for the tracer to be absorbed by your body.
During the PET scan
When you are ready, you'll lie on a narrow, padded table that slides into the scanner.
During the scan you'll need to lie very still so that the images aren't blurred. It takes
about 30 minutes to complete the test. The machine makes buzzing and clicking
sounds.
The test is painless. If you're afraid of enclosed spaces, you may feel some anxiety
while in the scanner. Be sure to tell the nurse or technologist about any discomfort. He
or she may give you a drug to help you relax.
In some cases you may have a CT and PET scan in the same machine during the same
appointment. The CT scan will be done first and take about 10 minutes.
After the PET scan
After the test you can carry on with your day as usual, unless your doctor tells you
otherwise. You'll need to drink plenty of fluids to help flush the tracer from your body.

Results

Pictures from a PET scan display bright spots where the radioactive tracer collected.
These spots reveal higher levels of chemical activity and details about how your tissues
and organs are functioning. A doctor specially trained to interpret scan images
(radiologist) will report the findings to your doctor.
The radiologist may also compare your PET images with images from other tests you've
undergone recently, such as computerized tomography (CT) or magnetic resonance

imaging (MRI). Or the pictures may be combined to provide more detail about your
condition.

How does a PET scan work?

Radiotracer
Before carrying out a PET scan, a radioactive medicine is produced in a cyclotron (a type of machine).
The radioactive medicine is then tagged to a natural chemical. This natural chemical could be glucose,
water, or ammonia. The tagged natural chemical is known as a radiotracer. The radiotracer is then
inserted into the human body.

PET scans can be used to diagnose a health condition, as well as for finding out how an existing
condition is developing. PET scans are often used to see how effective an ongoing treatment is.
When it is inside, the radiotracer will go to areas inside the body that use the natural chemical. For
example, FDG (fluorodeoxyglucose - a radioactive drug) is tagged to glucose to make a radiotracer. The
glucose goes into those parts of the body that use glucose for energy. Cancers, for example, use glucose
differently from normal tissue - so, FDG can show up cancers.

Detecting positrons
A PET scan detects the energy emitted by positively-charge particles (positrons). As the radiotracer is
broken down inside the patient's body, positrons are made. This energy appears as a 3-dimensional
image on a computer monitor.

The image
The image reveals how parts of the patients body function by the way they break down the radiotracer. A
PET image will display different levels of positrons according to brightness and color.
When the image is complete, it will be examined by a radiologist who reports the findings to the doctor. A
radiologist is a doctor who specializes in interpreting these types of images, as well as MRI scan, CT
scan, Ultrasound and X-ray images.

Why are PET scans required?


PET scans are used alongside X-rays or MRI (magnetic resonance imaging) scans. They are used to
make a diagnosis or to get more data about a health condition. As mentioned above, they are also useful
in finding out how effective current treatment is. The use of combined imaging technologies may hold the
key to stopping - and even preventing -heart attacks, a study revealed.
The biggest advantage of a PET scan, compared to an MRI scan or X-ray, is that it can reveal how a part
of the patient's body is functioning, rather than just how it looks. Medical researchers find this aspect of
PET scans particularly useful.
PET scans are commonly used to investigate the following conditions:

Epilepsy
It can reveal which part of the patient's brain is being affected by epilepsy. This helps doctors decide on
the most suitable treatments. MRI or CT scans are recommended for people after a first seizure, this
study explains.

Alzheimer's disease
It is very useful in helping the doctor diagnose Alzheimer's disease. A PET scan that measures uptake of
sugar in the brain significantly improves the accuracy of diagnosing a type of dementia often mistaken for
Alzheimer's disease, a study revealed.

Cancer
PET scans can show up a cancer, reveal the stage of the cancer, show whether the cancer has spread,
help doctors decide on the most appropriate cancer treatment, and give doctors an indication on the
effectiveness of ongoingchemotherapy. A PET scan several weeks after starting radiation treatment

for lung cancer can indicate whether thetumor will respond to the treatment, a study showed. This
article looks at whether PET scans are beneficial during cancer diagnosis, staging and monitoring.

Heart disease
A PET scan helps detect which specific parts of the heart have been damaged or scarred. Any faults in
the working of the heart are more likely to be revealed with the help of a PET scan. A study
revealed how comprehensive diagnosis of heart disease based on a single CT scan is possible.

Medical research
Researchers, especially those involved in how the brain functions get a great deal of vital data from PET
scans.

What is the difference between a PET scan and CT or MRI


scans?
A CT or MRI scan can assess the size and shape of body organs and tissue. However, they cannot
assess function. A PET scan looks at function. In other words, MRI or CT scans tell you what an organ
looks like, while a PET scan can tell you how it is working.

What happens during a PET scan?


In most cases, the patient does not have to spend the night in the hospital when having a PET scan.

A CT or MRI scan can assess the size and shape of body organs and tissue. However, they cannot
assess function. A PET scan looks at function. In other words, MRI or CT scans tell you what an organ
looks like, while a PET scan can tell you how it is working.
The majority of patients will be told not to consume any food for at least four to six hours before the scan,
but to drink plenty of water. Some will be asked to refrain from consuming caffeine for at least 24 hours
prior to the PET scan.
A small quantity of radiotracer will either be injected into the patient's arm or breathed in as a gas. The
radiotracer may take anything from 30 minutes to 90 minutes to reach the targeted part of the body. While
waiting for the radiotracer to reach its destination, the patient will normally be asked to stay still and not
talk. Some patients may be given some medication, such as diazepam, to relax.
When a patient is ready they will be taken to the room where the PET scan is and will lie down on a
cushioned examination table. The machine has a large hole which the table slides into. Then images of
the body are taken.
In many centers, the patient will be able to listen to music during the scan.
While the scan is in process, it is vital that the patient keep as still as possible. Depending on which part
of the body is being scanned, the whole process takes from about 30 to 60 minutes.
If the patient feels unwell, a buzzer can be pressed to alert the staff. During the whole process the patient
is being watched by staff.
The process is not painful.

Most patients can go home as soon as the scan has been done. Doctors advise people to consume lots
of liquids to flush the radioactive drugs out of their system more quickly. Experts say the radiotracers
should have left the body completely within three to four hours after entering the body.

Who should not have a PET scan?


Pregnant women and women who are breastfeeding should not have a PET scan as there is a risk for the
baby. Any woman who is pregnant should tell her doctor straight away (before the scan).
Anybody who has just had a PET scan should stay away from pregnant women, babies and young
children for a few hours after the scan.

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