Transcript of May 28 – 30, 2015, Montréal, Québec Carol-Anne Davis, RT(T), AC(T), DHSA, MSc.
- Slide 1
- May 28 30, 2015, Montral, Qubec Carol-Anne Davis, RT(T), AC(T),
DHSA, MSc
- Slide 2
- May 28 30, 2015, Montral, Qubec I do not have an affiliation,
financial or otherwise, with a pharmaceutical company, medical
device or communications organization. I have no conflicts of
interest to disclose ( i.e. no industry funding received or other
commercial relationships). I have no financial relationship or
advisory role with pharmaceutical or device-making companies, or
CME provider. I will not discuss or describe in my presentation at
the meeting the investigational or unlabeled ("off-label") use of a
medical device, product, or pharmaceutical that is classified by
Health Canada as investigational for the intended use.
- Slide 3
- PET-CT Over the past 20 years, positron emission tomography
(PET) and PET/CT (computed tomography) have revolutionized the care
of cancer patients in developed countries and are increasingly
being adopted in emerging economies. *Permission granted from
International Atomic Energy Agency: International Atomic Energy
Agency, Standard Operating Procedures for PET/CT: A Practical
Approach for Use in Adult Oncology IAEA Human Health Series 26,
IAEA, Vienna (2013). PET has been, and still is, one of the fastest
growing fields in medical imaging*
- Slide 4
- Research Question What proportion of non-small cell carcinoma
lung and head & neck squamous cell carcinoma patients have a
significantly different CTV due to the use of PET-CT?
- Slide 5
- Target Volumes: GTV, CTV high, low Extent of gross tumour, i.e.
what can be seen, palpated or imaged; this is known as the gross
tumour volume (GTV). Developments in imaging have contributed to
the definition of the GTV.
- Slide 6
- Target Volumes: GTV, CTV high, low The second volume contains
the GTV + a margin for sub-clinical disease spread which therefore
cannot be fully imaged; this is known as the clinical target volume
(CTV). It is the most difficult because it cannot be accurately
defined for an individual patient, but future developments in
imaging, especially towards the molecular level, should allow more
specific delineation of the CTV. The CTV is important because this
volume must be adequately treated to achieve cure.
- Slide 7
- Target Volumes: GTV, CTV
- Slide 8
- Target Volumes: GTV, CTV high, low GTV primary GTV nodes CTV
high risk (requires max dose) CTV low risk (requires lower
dose)
- Slide 9
- PET-CT is a powerful diagnostic imaging tool that combines
anatomic imaging (CT) with physiologic data (PET) courtesy of G
Segall (Stanford University) through the PET PROS program of the
SNM PET Center of Excellence.
http://www.snm.org/index.cfm?PageID=10044 PET-CT is sensitive and
specific for cancer
- Slide 10
- PET Stands for positron emission tomography
Fluorine-18-deoxyglucose (18-FDG), a radionuclide labeled glucose
analogue, is injected and the pt is imaged 18F-fluorodeoxyglucose
(FDG) is taken up by cells proportionate to their metabolic
rates
- Slide 11
- Quite simply Malignant cells take inherently have a higher
metabolism than non-malignant cells. They have a higher mitotic
rate as well as more inefficient aerobic metabolism leading to more
anaerobic metabolism Through these mechanisms, malignant cells will
take up the FDG at a faster rate and this will can be seen on the
scan as the FDG decays.
- Slide 12
- CT - Topogram (scout) - CT scan (1 min) PET - Brain (10 min) -
Heart (10 min) - Body (20 min)