Download - Molecular Imaging and Cancer
Molecular Imaging in Cancer
Chaitanya Divgi, MDProfessor of Radiology & Radiation Oncology
Chief, Nuclear Medicine & Clinical Molecular ImagingDepartment of RadiologyUniversity of Pennsylvania
OverviewMolecular Imaging is critical to cancer patient management:
•Diagnosis may be made earlier and more accurately•The extent and location of the disease
may be more accurately estimated, before and after treatment.•Treatments may be better selected, and
unnecessary procedures avoided.•The effect of treatment, and the severity
of the disease, may be better assessed.
Positron Emission Tomography (PET)
• PET revolutionized functional imaging by providing exquisite snap-shots
• 18FDG PET/CT standard of care for staging disease and response evaluation
• May be the best indicator for recurrent disease
PET and PET/CT
• Medicare and CMS has approved the use of FDG PET/CT for a variety of cancers.
• A recent study showed that imaging with FDG PET/CT could affect patient care significantly in about a third of patients with cancer.
Response to Hormonal Therapy
Pre-Rx Post-Rx
FES FDG FDG• Newly Dx’d met breast CA
• ER+ primary
• FES-negative bone mets
University of Washington
• Recurrent sternal lesion
• ER+ primary
• Recurrent Dz strongly FES+
Example 1
Example 2
(Linden, J Clin Onc, 2006)
Surgery may be avoided or tailored based on tumor characteristics
Divgi et al, Lancet Oncol. 2007; 8 : 304-10.
Response evaluation by PET
Changes in tumor characteristics precede structural change and predict overall therapeutic outcome