Patient Education & Consent
Prior to undergoing any medical procedure, patients need to be fully informed as to how to prepare, what to expect during the procedure, and the clinical benefits of the procedure. The alternatives, benefits, and risks should be fully understood.
Patient Instructions
Patients undergoing F-18 FDG PEM need to fast for 4-6 hours prior to the procedure.
Patients with diabetes should ensure that their blood sugar levels have been under control for several days before undergoing PEM. If it is elevated, the scan may need to be rescheduled. Following a low-carbohydrate, high-protein diet for a day or two prior to the scan is also recommended. After the procedure is completed, no further special precautions need to be taken.
Equipment
Breast PET scanning is currently performed with a portable PET camera, which consists of two flat camera plates between which the breast is placed during scanning. The camera plates are mobile in order to allow different imaging positions. The field of view is approximately 16 cm x 24 cm, and the spatial resolution is about 1-3 mm. Although the imaging plates are flat, 3-dimensional tomographic images are obtained.
PET scanners work by detecting photons released after a positron decay particle from the radionuclide annihilates with an electron. When the photons strike the detection crystal, a small amount of light is emitted. This light is then converted to digital form for interpretation. Currently, pixilated lutetium yttrium orthosilicate (LYSO) crystals are used for photon detection. [16]
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Grade III multifocal infiltrating ductal carcinoma as seen on F-18 fluorodeoxyglucose positron emission tomography . This organ specific positron imaging technique results in a much higher resolution (down to 1 to 2 mm) compared to whole body PET/CT imaging.
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This image demonstrates the ability of positron emission tomography to quickly assess response to chemotherapy, as early as 1 week after the first cycle. (Images courtesy of Mary K. Hayes, MD, Memorial Healthcare System, Hollywood, FL)
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This image shows the ability of positron emission mammography to help ensure a breast biopsy is taken in the best location. The most metabolically active tissue needs to be evaluated for malignancy. The top image is obtained right before performance of the biopsy. The bottom image shows the biopsy needle to be properly positioned.
