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Clinical PET Cast

Peter Faulhaber, MD

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CPC-050 PET/MRI (Part 3) Attenuation and Future Protocols

In this third episode on PET/MRI, we’ll focus on the overall goals for using MRI instead of CT with PET, namely less radiation and more accuracy. These properties have particular benefits in pediatrics and neurology that I’ll discuss. We’ll review the active area of protocol development with PET/MRI, including the issues in attenuation correction. Finally, we’ll look at emerging tracers that could add to some of the excitement over PET/MRI.


9 Aug 2013

Rank #1

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CPC-049 PET/MRI (Part 2) TNM Staging and Acquisition

While PET/MRI continues to be a very hot topic in the literature, we’re still not quite sure how to use it. So, to continue the discussion about PET/MRI, we’ll use the transition from PET to PET/CT as a model. We’ll look at the potential benefits PET/MRI may bring to TNM staging and discuss what may be possible for therapy assessment. I’ll also get into some design strategies for combining PET and MRI hardware so that they can be used in one session.


26 Jul 2013

Rank #2

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CPC-048 PET/MRI (Part 1) The Promise of Less Dose

In this episode, we’ll dive into the exciting new technology of PET/MRIs. We can learn a lot from our history, and I’ll discuss what image fusion and PET/CT hardware have provided us over the years. But while PET/CT has certainly helped our accuracy in staging, I’ll use a pediatric example to point out how PET/CT can also lead to more dose. Because of the possibility of lower dose and other potential gains, I’ll discuss the reasons PET/MRI scanners hold such promise.


12 Jul 2013

Rank #3

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CPC-047 Techniques for Consistent Evaluation

In this episode, I’ll continue to discuss the evaluation of response to therapy using PET. A number of factors affect when to assess therapy response and how to interpret the results, and there are differences between radiation therapy and chemotherapy. Within radiation therapy, it is very important to consider the particular disease, so I’ll discuss specifics for ovarian, cervical, lung, colorectal, and liver cancer. Most of this discussion uses data on the popular FDG tracer, but I will also mention some of what we have to look forward to with newer isotopes.


28 Jun 2013

Rank #4

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CPC-046 Therapy Assessment

In this episode we will be looking at PET/CT and the evaluation of different therapeutic interventions. More and more, the interest in PET/CT is not only in the initial evaluation of disease, but also in the subsequent evaluation of therapy response. We will look at the literature to discuss the different recommended standards for defining the disease’s response as complete, partial, stable, or progressive.


14 Jun 2013

Rank #5

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CPC-045 Reporting – Combating Ambiguity

A journal article I read recently had several amusing examples of  “unremarkable” words. This illustrates how easy it is for reports to  contain phrases that only the writer can clearly understand. While some  issues are caused by dictation technology and the tendency of us humans  to occasionally “zone out,” we can still improve the quality of our  reports by following templates and a list of required elements. In this episode, I’ll illustrate this process using a typical report from our site.


3 May 2013

Rank #6

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CPC-044 Reporting – Language Clarity

In this episode, I’ll discuss the issues of unclear language in written reports. With the growing use of EMR and demands for quick turnaround time, we’re spending less face time with our colleagues. This episode I’ll particularly focus on some studies concerning terminology, and how synonyms can make it difficult to determine to what degree an abnormality is present.


19 Apr 2013

Rank #7

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CPC-043 Prostate Cancer

In this episode I’ll discuss prostate cancer and PET. Prostate imaging with PET remains unapproved for reimbursement by CMS, and we’ll examine several reasons why this is the case. One of the major limitations has to do with the tracers available, and along those lines I’ll talk about radiopharmaceuticals currently under investigation.


8 Apr 2013

Rank #8

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CPC-042 Head & Neck Malignancies

I’ll continue the discussion of head and neck malignancies and reporting. Every PET/CT report needs to discuss the Tumor (T), the presence of regional lymph nodes, and the presence of metastases. A well-written and organized report will make your clinical and surgery colleagues quite happy with the results.


11 Mar 2013

Rank #9

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CPC-041 Head & Neck and PET/CT

Today I’ll continue our discussion of head and neck cancer and PET/CT by going through a number of studies important to both. Several of these studies provide illuminating data by comparing PET/CT to either PET or CT data alone, including data from high-contrast CT. We’ll see how PET/CT can increase the confidence of the radiologist and even find disease in head and neck patients otherwise considered cured.


24 Feb 2012

Rank #10