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Developments in PET/CT medical visualization

The PET/CT market is defined by four major trends, each of which brings a significant element of technology advancement with it.

• The first is the broadening acceptance of PET/CT as an important tool in the diagnosis and staging of cancer. As the recognition of the value of PET/CT in treatment planning for cancer grows, there will be a strong need for technologies that improve the acces- sibility of this diagnostic tool through lower capital and operating costs, easier usability, and tools to reduce variability in the exam reads.

• The second trend is the use of PET/CT in therapy monitoring. That has tremendous potential to improve both the quality and cost, and personal- ize the care that cancer patients get by being able to assess if a particular treatment regime is being effective for that patient in much shorter time than currently done with other imaging modalities. Tech- niques that improve quantitative accuracy, effective motion management to reduce variability, and lesion

tracking are technologies that will have a significant impact on therapy monitoring.

• The third is the research and development of new PET tracers to expand the reach of PET beyond oncol- ogy imaging based on FDG. While very effective in many oncology applications, use of FDG on PET/CT has some well-known limitations in certain applica- tions, like imaging of the liver, prostate, certain brain metastasis, neurological disorders, and some cardiac imaging. There is a lot of exciting research work on both molecules and clinical applications which will further expand the utility of PET/CT imaging.

• The fourth, equally important trend is the emer- gence of the new hybrid modality combining PET and MR. Combining the information from PET and MR, or combining them into one piece of equipment, is a technology challenge but the real advancement is in understanding what the clinical utility of the combined information is going to be, and whether it can be done in a cost effective way.

There are two distinct technology solutions that enable researchers to answer the ques- tion about the clinical value of combining PET and MR.

• The first approach commonly referred to as the sequential solution is one where the patient is held in a fixed position while being moved between the PET and MR scans, and the images obtained fused with advanced software algorithms. This approach provides clinicians with the ability to answer a majority of their questions about the value of PET and MR compared to the existing standard of PET/CT, and doing it in a cost effective way.

• The other approach is to combine the PET and MR into a single machine, which has the advantage of offering simultaneous imaging for some high end research involving specialized tracers where the clinical value is still to be established.

- Within the group of simultaneous systems there are two distinct approaches —

Whether the PET detector is based on APD (avalanche photo diodes) or SSPM (Solid State or Silicon Photo Multiplier). While both of them have the advantage of being capable of operation in an MR environ- ment, the difference is in the performance of the PET detectors where SSPM has the advantage of much higher gains and capability of doing TOF (time of flight) imaging that has become a key feature for a lot of the research work around the world. The clinical and research community, through various publications, has been pretty open that the benefits offered by SSPM (alternately referred to as SiPM) make it the detector of choice for a combined PET and MR system going forward which many groups are working on, and a system based on it is eagerly awaited.



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