Positron emission tomography (PET) is a specialized radiology procedure used to examine various body tissues to identify certain conditions or follow the progress of the treatment of certain conditions. While PET scan is most commonly used in the fields of neurology, oncology, and cardiology, applications in other fields are currently being studied.
PET scan is a type of nuclear medicine procedure. This means that a tiny amount of a radioactive substance, called a radionuclide (radiopharmaceutical or radioactive tracer), is used during the procedure to assist in the examination of the tissue under study. Specifically, PET studies evaluate the metabolism of a particular organ or tissue, so that information about the physiology (functionality) and anatomy (structure) of the organ or tissue is evaluated, as well as its biochemical properties. PET scan may detect biochemical changes in an organ or tissue that can identify the onset of a disease process before anatomical changes related to the disease can be seen with other imaging processes such as CT scan or MRI.
PET scan is most often used by oncologists (physicians specializing in cancer treatment), neurologists and neurosurgeons (physicians specializing in treatment and surgery of the brain and nervous system), and cardiologists (physicians specializing in the treatment of the heart). However, as advances in PET technologies continue, this procedure is beginning to be used more widely in other areas.
PET scan is also being used in conjunction with other diagnostic tests such as computed tomography (CT) to provide more definitive information about malignant (cancerous) tumors and other lesions. The combination of PET and CT shows particular promise in the diagnosis and treatment of lung cancer.
PET scans work by using a scanning device (a machine with a large hole at its center) to detect positrons (subatomic particles) emitted by a radionuclide in the organ or tissue being examined.
PET scans use chemical substances such as glucose, carbon, or oxygen that are used naturally by the particular organ or tissue during its metabolic process. A radioactive substance is attached to the chemical required for the specific tests. For example, in PET scans of the brain, a radioactive substance is applied to glucose to create a radionuclide called fluorodeoxyglucose (FDG), because the brain uses glucose for its metabolism. FDG is widely used in PET scanning.
Other substances may be used for PET scanning, depending on the purpose of the scan. If blood flow and perfusion of an organ or tissue is of interest, the radionuclide may be a type of radioactive oxygen, carbon, nitrogen, or gallium.
The radionuclide is administered into a vein through an IV line and allowed to circulate the specific organ before the image can be taken. Next, the PET scanner slowly moves over the part of the body being examined. Positrons are emitted by the breakdown of the radionuclide. Gamma rays are created during the emission of positrons, and the scanner then detects the gamma rays. A computer analyzes the gamma rays and uses the information to create an image map of the organ or tissue being studied. The amount of the radionuclide collected in the tissue affects how brightly the tissue appears on the image, and indicates the level of organ or tissue function.
In general, PET scans may be used to evaluate organs and/or tissues for the presence of disease or other conditions. PET may also be used to evaluate the function of organs such as the heart or brain. Another use of PET scans is in the evaluation of the treatment of cancer.
More specific reasons for PET scans include, but are not limited to, the following:
There may be other reasons for your physician to recommend a PET scan.
Generally, a PET scan follows this process:
While the PET scan itself causes no pain, having to lie still for the length of the procedure might cause some discomfort or pain, particularly in the case of a recent injury or invasive procedure such as surgery. The technologist will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort or pain.
You should move slowly when getting up from the scanner table to avoid any dizziness or lightheadedness from lying flat for the length of the procedure.
You will be instructed to drink plenty of fluids and empty your bladder frequently for 24 to 48 hours after the test to help flush the remaining radionuclide from your body.
The IV site will be checked for any signs of redness or swelling. If you notice any pain, redness, and/or swelling at the IV site after you return home following your procedure, you should notify your physician as this may indicate an infection or other type of reaction.
Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.