The University of Southern California PET Center is recognized as one of the leading PET centers in the world. The director of the USC PET Center, Dr. Peter Conti, is a distinguished leader in the nuclear medicine community. He and one of his top nuclear medicine fellows, Dr. Daniel Cham, will publish the first PET-CT case based book available in the marketplace. The text is heavily illustrated with original detailed PET-CT images of both common and uncommon cancer cases. Each of the clinical applications discussed is accompanied by a comprehensive description of the history, imaging techniques, and the interpretation and impression of the PET-CT case. Additionally, a section on "pearls and pitfalls" and clinical follow-up will help physicians gain a better understanding of the pathology and its changes during growth.
Few advances in medicine have had more of an impact on modern health care than the invention of PET-CT studies of FDG in the living human body and experimental animals. Biochemistry has been superimposed on anatomy, which is a giant leap forward. The expertise required for the interpretation of CT must now be combined with the expert interpretation of the biochemical information of the FDG study. The idea that the interpretation of the images simply requires the superimposition of the two image modalities is simple is clearly not true. What is needed is a clear und- standing of the sites of metabolic activity revealed by FDG studies in normal persons, and its variability from person to person. For example, FDG accumulates in various structures in the head and neck,and in the ovaries and uterus of normal women during certain phases of the menstrual cycle. The case method of teaching has stood the test of time for more than a hundred years and is still valid as new modalities are developed and introduced into medical practice. The authors,both of whom have considerable experience in the performance and interpretation of PET-CT studies with FDG, have made an important contri- tion that will be of great value to nuclear medicine physicians,radiologists,oncologists, and other physicians with the responsibility of caring for patients with cancer. Capabilities and limitations are discussed in the context of speci?c problems and patients.
Henry N. Wagner, Jr. Preface......Acknowledgments....Contributing AuthorsContents In Brief...... Part I: The Fundamentals Normal Physiology and Variants: A Primer...........Daniel K. Cham, Peter S. Conti01-01: Normal Physiology01-02: Non-Oncologic Pathology01-03: Post Therapeutic Changes01-04: Foreign Body Artifact01-05: Technical ArtifactPart II: Clinical Cases Adrenal Cancer.....Heidi R. Wassef02-01: 72-year-old man with previous resection of right adrenal carcinoma now being evaluated for bulk recurrent disease, evident on recent CT. Germ Cell Tumors: Choricocarcinoma and Testicular Cancer........Anabella S. Din, Peter S. Conti03-01: 25-year-old male status post left orchiectomy with lesions involving the back, mediastinum, abdomen and the left neck, and an elevated beta-HCG and AFP level.03-02: 26-year-old male status post orchiectomy, chemotherapy and radiotherapy.03-03: 55-year-old man status post left orchiectomy, pelvic bone resection and left groin lymph node dissection.03-04: 34-year-old woman with a history of metastatic choriocarcinoma confirmed with nodulectomy during a right thoracotomy, currently presenting with rising HCG. Brain..Sherief Gamie, Peter S. Conti04-01: 75-year-old woman with suspected temporal glioblastoma for recurrence.04-02: 73-year-old male who has a history of brain mass and pulmonary carcinoid.04-03: 81-year-old male who has a history of angiosarcoma.04-04: 38-year-old female with multiple brain lesions.04-05: 46-year-old male who has a history of suprasellar mass now presenting with left eye blindness.04-06: 21-year-old male with a seizure disorder.04-07: 62-year-old female who has a history of glioma.04-08: 53-year-old female with multiple sclerosis and worsening headache for two months. Breast Cancer...Hossein Jadvar05-01: 53-year-old female with a history of breast cancer and fibrous histiocystoma.05-02: 57-year-old female with a history of left breast cancer, with right pleural and left mid lung metastases.05-03: 48-year-old female with reported small right axillary mass on ultrasound.05-04: 56-year-old female who has a history of breast cancer status post left lumpectomy.05-05: 36-year-old female who has a history of breast cancer and positive neck biopsy.Gynecologic Malignancies: Cervical, Uterine, and Vulvar Cancer .......Hossein Jadvar06-01: 32-year-old female who has a history of cervical cancer and positive pelvic and abdominal lymphadenopathy.06-02: 69-year-old woman with a history of metastatic cervical cancer in the neck and abdomen.06-03: 50-year-old female who has a history of cervical cancer with metastatic disease to lung.06-04: 32-year-old woman s/p hysterectomy and right oophorectomy for uterine cancer and a left upper lung mass.06-05: 78-year-old female s/p vulvectomy and local radiotherapy for vulvar cancer with a subcutaneous mass in the left groin. Colorectal Cancers....Robert W. Henderson07-01: 62-year-old male with a history of colon cancer s/p chemotherapy; comparison to positive basal PET study.07-02: 56-year-old woman with a history of colon CA status post chemotherapy and radiofrequency ablation in the liver, now with rising CEA level.07-03: 59-year-old male status post left hemicolectomy with rising CEA level.07-04: 51-year-old woman with a known metastatic disease for colon carcinoma.07-05: 42-year-old male with a recent diagnosis of low rectal tumor by biopsy being staged with PET. Cholangiocarcinoma.....Heidi R. Wassef08-01: 74-year-old male who has a history of extrahepatic cholangiocarcinoma s/p Whipple procedure and