Diagnosis

In this example, a solitary lung nodule was identified on a routine chest x-ray. For diagnosis, a whole-body FDG PET•CT study was performed. With fast image loading, the entire case is loaded within seconds and displayed in your selected default layout. In this example, a solitary lung nodule was identified on a routine chest x-ray. For diagnosis, a whole body FDG PET•CT study was performed. With fast image loading, the entire case is loaded within seconds and displayed in your selection default layout. For a quick overview, the CT, PET, fused PET•CT and the MIP animation are displayed simultaneously. With multi-modality capability, images from any PET, SPECT, CT and MR scan can be displayed and automatically fused. For your selection VOI's, the Oncology Engine automatically draws iso-contours and provides quantifications such as maximum and aveage SUV's, CT HU values and volume measurements. This study shows high FDG uptake in the lung nodule with a maximum SUV of 22.9.

Staging

This image shows a whole-body FDG PET•CT study for primary staging of a lympho ma patient. The application provides the PET MPR, a rotating MIP, as well as correlated cursors to pinpoint ROIs in the anatomical and functional studies. The alpha blender gives you full control over the fused display — to switch from 100% functional to 100% anatomical. This study shows multiple FDG-avid malignant nodes in both axilla, the right supraclavicular nodes as well as in multiple vertebrae, the liver, the trochanter of right femur and the left acetabulum. The presence of disease on both sides of the diaphragm is suggestive of stage IV lymphoma.

Therapy Planning

This clinical case shows a respiratory gated whole-body FDG PET•CT study of a lung cancer patient. The tumor is located adherent to the aortic wall. Hence, an accurate assessment of tumor motion and viable tumor tissue is required for therapy planning. Using the Oncology Engine you can draw iso-contours based on pre-defined SUV levels within your VOIs. They can be manually adjusted and then propagated across all gates. The defined contours can be exported as DICOM RT Structure Sets to leading RTP systems from Siemens, Varian Eclipse, ADAC Pinnacle, CMS, Brainlab, and Nucletron.

Treatment and Follow-Up

In this clinical example, a patient with ovarian carcinoma was treated with chemo therapy. Three sequential FDG PET•CT studies were performed to assess the response to therapy. The first study, performed shortly after therapy, shows increased FDG uptake throughout the bone marrow, typical of a post chemotherapy flare reaction. No well defined metastatic foci are present. The second study, performed three months later, shows a new solitary mediastinal nodule, which is either inflammatory in origin or suggestive of early metastasis. The third study, done after 5 months, shows multiple lung, mediastinal, and pleural FDG avid nodules, suggesting an increase in total metastatic burden and hence, disease progression. Longitudinal studies can be easily compared both visually and quantitatively. Up to three time points may be displayed in selectable layouts. VOIs can be copied across time points with one click. The reference lines are aligned to corresponding areas, while the images remain unchanged. For a quick trending overview and reporting purposes, a percent change table is available, delivering quantitative data on therapy response at a glance. To promote these advanced capabilities as part of your diagnostic services, the reporting features include PDF and RTF export, inclusion of your logo, and one click print and CD generation.



Case studies are for informational purposes, and are not meant to substitute for clinician judgment in how best to use any medical devices. It is the clinician that makes all diagnostic determinations based upon education and experience