PET CT Simulation
PET/CT imaging is the acquisition of molecular uptake information and anatomical information in one inherently registered image. PET/CT imaging provides the radiation oncologist with an invaluable tool to determine areas of active cancer versus normal structures for use in conjunction with Intensity Modulated Radiotherapy and Image Guided Radiotherapy. One of the greatest advantages that PET/CT holds is the potential to increase the radiation dose to small areas that are at greatest risk, without incurring a penalty in terms of toxicity.
The Department of Radiation Oncology has employed the use of dedicated PET/CT (General Electric ST-8 PET/CT) imaging since early 2005, becoming one of the first departments usher in the concept of PET/CT simulation as part of our Bio-Anatomic Imaging ant Treatment (BAIT) program. A PET/CT scanner provides the best of both worlds; CT scanning (computed tomography) which provides excellent detail for structural information, and PET scanning (positron emission tomography) which provides metabolic information on a cellular level. It has been demonstrated that when combined, PET/CT imaging can vastly improve identification and staging of tumors with accurate localization. This precise localization aids the physician with better target definition and thus allows for the most optimal treatment plan to the smallest volume of tissue. With our dedicated PET/CT Simulation suite, the patient is scanned in treatment position with the appropriate treatment aid devices obtaining all the image information in one setting.
At WFUBMC, we are currently utilizing PET/CT simulation for a wide variety of sites including head/neck, esophageal, lung, gynecological, and others. Due to the accuracy needed for our stereotactic body radiotherapy (SBRT) program, the majority of our SBRT patients will undergo this imaging procedure.
4D Imaging
The motion of breathing can have a tremendous impact on the way volumes in the lung and upper abdomen are treated. This breathing motion can change the location, size and shape of internal structures. These changes are patient and location dependent. In order to take into account this motion for radiotherapy planning, WFUBMC has become one of the first in the region to adopt 4D (4-dimensional) imaging for radiotherapy planning with the aid of CT and one of the first in the nation to adopt 4D imaging with PET. This technology gives the physician a clear picture of tumor and normal tissue motion during the respiratory cycle for customized margins and potentially respiratory gated treatment. This is technology is most crucial for areas in the lung and upper abdominal regions.