Breast Positron Emission Tomography Periprocedural Care

Updated: Sep 01, 2014
  • Author: Thomas F Heston, MD, FAAFP, FASNC, FACNM; Chief Editor: Gowthaman Gunabushanam, MD, FRCR  more...
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Periprocedural Care

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. 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.

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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. PEM scanners under development include cameras that utilize cerium-doped LYSO and pixelated cadmium zinc telluride crystals. [11]

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Patient Preparation

Upon arrival at the clinic, the patient’s blood sugar is checked. If it is elevated, the scan may need to be rescheduled.

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Monitoring & Follow-up

Women who are breastfeeding typically will stop breastfeeding for an hour or two after the PEM scan has been completed. After this, breastfeeding is resumed as normal.

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