Technology Insight: advances in molecular imaging and an appraisal of PET/CT scanning

PET/CT imaging has rapidly emerged as an important imaging tool in oncology and provides multiple exciting new opportunities to integrate functional and morphological information for tumor staging, radiation treatment planning and monitoring of tumor response to therapy. In this Review, the authors discuss the technical features of PET/CT and its role in diagnosis, staging, restaging and treatment monitoring as well as radiation planning in cancer patients. PET/CT imaging has rapidly emerged as an important imaging tool in oncology. The success of PET/CT imaging is based on several features. First, patients benefit from a comprehensive diagnostic anatomical and functional (molecular) whole-body survey in a single session. Second, PET/CT provides more-accurate diagnostic information than PET or CT alone. Third, PET/CT imaging allows radiation oncologists to use the functional information provided by PET scans for radiation treatment planning. In this Review we discuss the technical features of PET/CT, its economic aspects within the health-care system, and its role in diagnosis, staging, restaging and treatment monitoring as well as radiation planning in patients with cancer. Key Points PET/CT with the glucose analog [18F]fluorodeoxyglucose has emerged as an important tool for staging and restaging a variety of malignant tumors PET/CT has been shown to be more accurate for detection of metastatic lesions than either PET or CT alone By providing functional and morphological information in a single examination, PET/CT can shorten the diagnostic workup of cancer patients PET/CT allows the functional information of PET to be used for radiation treatment planning purposes PET/CT will facilitate the clinical use of new molecular imaging probes by showing the exact anatomical localization of their distribution in normal organs and in tumors