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Appropriate indications for positron emission tomography/computed tomography: College of Nuclear Physicians of the Colleges of Medicine of South Africa

Mike Sathekge, James M Warwick, Alex Doruyter, Mariza Vorster

Abstract


Individualised patient treatment approaches demand precise determination of initial disease extent combined with early, accurate assessment of response to treatment, which is made possible by positron emission tomography/computed tomography (PET/CT). PET is a non-invasive tool that provides tomographic images and quantitative parameters of perfusion, cell viability, and proliferation and/or metabolic activity of tissues. Fusion of the functional information with the morphological detail provided by CT as PET/CT can provide clinicians with a sensitive and accurate one-step whole-body diagnostic and prognostic tool, which directs and changes patient management. Three large-scale national studies published by the National Oncologic PET Registry in the USA have shown that imaging with PET changes the intended patient management strategy in 36.5% to 49% of cases, with consistent results across all cancer types. The proven clinical effectiveness and growing importance of PET/CT have prompted the College of Nuclear Physicians of South Africa, in collaboration with university hospitals, to develop a list of recommendations on the appropriate use of fluorine-18-fluorodeoxyglucose (18F-FDG) and non-18F-FDG PET/CT in oncology, cardiology, neurology and infection/inflammation. It is expected that other clinical situations will be added to these recommendations, provided that they are based upon solid clinical evidence. These recommendations are intended to offer advice regarding contemporary applications of PET/CT, as well as indicating novel developments and potential future indications. The CNP believes that these recommendations will serve an important and relevant role in advising referring physicians on the appropriate use of 18F-FDG and non-18F-FDG PET/CT. More promising clinical applications will be possible in the future, as newer PET tracers become more readily available.

Authors' affiliations

Mike Sathekge, Department of Nuclear Medicine, Steve Biko Academic Hospital and Faculty of Health Sciences, University of Pretoria, South Africa

James M Warwick, Division of Nuclear Medicine, Tygerberg Academic Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa

Alex Doruyter, Division of Nuclear Medicine, Tygerberg Academic Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa

Mariza Vorster, Department of Nuclear Medicine, Faculty of Health Sciences, University of Pretoria, South Africa

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Keywords

Positron emission tomography/computed tomography; PET/CT; Indications

Cite this article

South African Medical Journal 2015;105(11):894-896. DOI:10.7196/SAMJ.2015.v105i11.10180

Article History

Date submitted: 2015-10-08
Date published: 2015-10-08

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