Clinical case - Improvement in the localization accuracy

Localization Accuracy

Who we are

Doctor Catherine Tainturien, MD
Head of Nuclear Medicine Department

Doctor Elise Le Stanc, MD
Nuclear Medicine Physician

 

Hôpital Foch,
Suresnes, France

We are a Nuclear Medicine Department in a general hospital close to Paris (France).

Our facilities comprise one gamma-camera, one SPECT/CT and one PET/CT.

Our hospital is a multidisciplinary one, with high surgical and oncological activities.

We mainly perform 18F-FDG PET/CT scans for patients presenting with lymphoma, head and neck, lung and digestive carcinomas.

Patient History

Male - 75 years old - 165cm - 70kg

Rectosigmoid colon adenocarcinoma in 2005, pelvic recurrence in 2007, both treated surgically.

In 2008 , a new hepatic nodule found on CT and increased CEA.

Patient referred to 18F-FDG-PET/CT for recurrence staging.

Acquisition

Scanner: GE Discovery STE

PET acquisition: Whole-body static and MotionFree acquisition

  • 3D acquisition using VUE Point HD reconstruction
  • Acquisition time:
    • Whole-body acquisition: 3 min/bed
    • MotionFree acquisition: 6 bins - 2 min/bin
  • Post-injection time: 1h50 min
  • Dose: 288 MBq of 18F-FDG

CT acquisition:

  • Static CT Attenuation Correction whole-body acquisition
  • MotionFree acquisition both for CTAC and diagnosis

 

Findings

                    

The circle points out an abnormal focus which appears
localized in the right lung

                    

Fused MotionFree PET & CT images shows the uptake
localization in the liver hepatic dome

The static whole-body scan shows a colic recurrence
(focal intense uptake close to the midline). A second
abnormal focus is localized in the right lung base.

The MotionFree acquisition confirms the uptake localization
in the hepatic dome of the liver and not in the right lung base
as it seems to be on the static whole-body scan.

Conclusion

The whole-body scan localizes the lesion in the right lung base.

MotionFree allows to account for tumor motion due to patient breathing, giving a clear vision of the lesion’s location at the top of the liver.