Nuclear Medicine Institute

PET / CT is one of the most modern examinations in modern medicine. It makes it possible to detect a number of pathological conditions, especially in oncology, cardiology, neurology, pneumology, urology, and is also used in the detection of inflammatory and degenerative processes. It consists of two examinations - positron emission tomography (PET) and computed tomography (CT). While PET determines the degree of cell damage, CT (computed tomography) determines the exact location of the affected lesion. The examination is usually performed in the range of head to thigh, or whole body. The following are used as PET radiopharmaceuticals (medicinal, possibly diagnostic preparation with bound radioactive substance) at our workplace:

• FDG: Radiofluorin-labeled sugar (fluorodeoxyglucose), which accumulates in cells with increased metabolism, often tumor or inflammatory cells, most commonly used in the diagnosis of lymphomas, lung tumors, melanoma, and various infectious or non-infectious inflammatory conditions. The most commonly used substance.
• Flucyclovin (FACBC, Axumin): an artificial amino acid designed to search for tumor foci in suspected prostate cancer recurrence
• Choline: a substance that is involved in the formation of cell membranes and is also used to localize prostate tumors, as well as liver cancer, ev. may contribute to the search for enlarged parathyroid glands.
• F-DOPA: part of the production of hormones of the adrenal medulla, used to search for tumors with their increased production (pheochromocytoma, paraganglioma, certain types of thyroid tumors - medullary carcinoma)
• FLT: a substance that is involved in the production of DNA (fluoro-L-thymidine), allows the localization of areas of increased cell division, is used to determine the effect of radiation therapy - radiotherapy.

The amount of radiopharmaceutical administered to the body is very small and is administered intravenously.

Subsequent CT scans are usually performed using iodine contrast, which, at the physician's discretion, is given into a vein or drunk. CT examination is performed in order to determine the location of the pathological lesion and assess the structural changes of the organs and is also optimized to minimize the radiation exposure. The contrast agent makes it possible to assess individual tissues in the body of the examined person and to distinguish pathological changes from healthy parts.

The radiopharmaceutical has practically no side effects, does not cause allergies or other health complications. The contrast agent can cause an allergic reaction, which is usually mild in nature (sneezing, feeling hot, nausea), with more severe reactions (shortness of breath, swelling, etc.), immediate help is available at the ward. Very rarely, life-threatening allergic reactions have occurred in the world.

The daily capacity in two-shift operation is about 15 patients per day (depending on the type of examination, less so in more complex types of examinations).

The examination lasts approximately three hours, the procedure and duration may vary for individual radiopharmaceuticals. Due to irregular deliveries and variability of operation, it is not possible to plan everything exactly and PET / CT examinations are often associated with longer waiting times. For the most commonly used FDG, it takes place in the following phases:

• preparation before application: the patient is in the waiting room, administrative reception, insertion of an intravenous needle (cannula), instructions and signature of informed consent,
• FDG application: intravenously (total approx. 5 min.),
• waiting for the accumulation of FDG in the body: the patient is in a separate box, stays still (lasts 1-2 hours),
• PET / CT scanning: usually with the application of a contrast agent into an already inserted cannula (the patient is "in the tunnel" of the device - it takes about 30 minutes)
• image and patient control: approx. 30 minutes before the computers process and create an evaluable image (checking the patient for the development of an allergic reaction or other complications).