20Jan 2017

THE EFFECTIVE VALUE OF PET/CT IN DIAGNOSING CARDIOVASCULAR DISEASE AND PEDIATRIC CANCER;A COMPARATIVE STUDY

  • Assistant Prof. of Safety and Prevention of Oncologyin Radiation protection Department.
  • Lecturer in Radiation Safety Department.
  • Assistant Prof. of Applied Statistic in Radiation Safety Department, Nuclear and Radiological Regulatory Authority,Cairo, Egypt.
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Overview:Combined PET/CT systems have emerged as promising imaging modalities and are being more routinely used in clinical situations. 18F-FDG PET/CT is an established entity in the work-up of several oncologic disorders and is making forays in the diagnosis of inflammatory diseases, leading to increased use for cardiac and neurologic applications. Although PET is on the move in cardiovascular medicine and new developments are likely to increase its application and impact in clinical practice, some similarities and interrelationships between its cardiac applications and applications for tumor imaging should be noted. The study aimed to prospectively study the clinical experience with PET/CT in Cardiac diseases and in pediatric malignancies to evaluate and compare the efficacy of this imaging system in both diseases, and to determine if it provided additional diagnostic information on the disease status. Methodology:Thirty two cardiac patients with previous history of myocardial infarction & left ventricular dysfunction and coronary artery disease (CAD) were underwent the imaging procedures consisting of PET/CT,echocardiography and invasive angiography. Diagnostic sensitivity of these less invasive modalities for detection of myocardial viability was compared to invasive coronary angiography. Additionally, 54 pediatriccancerpatients were included in this study [28 had lymphoma and 26 had soft tissue sarcoma (STS)]. Seventy two scanswere performed for whole body in all patients for initial diagnosis and staging. Results:In the current study,Coronary angiography was used as the gold standard;PET/CT has high diagnostic value in the assessment of myocardial viability when compared to echocardiography;and also in malignant disease if distant metastases or second primary tumors are detected with regard to staging of the primary tumor.It may influence the treatment decision in both diseases.The diagnostic sensitivity of cardiac PET/CT, cardiac angiography and echocardiography was 98.2%, 93.4% and 82.5%, respectively. Diagnostic sensitivity of PET/CT in myocardial viability at per-vessel based assessment was80.2% for LAD (left anterior descending), 77.6% for LCX (left circumflex), and 100% for RCA (rightcoronary)coronary arteries. The overall sensitivities, specificities & positive and negative predictive values of the imaging system for all the suspicious sites in pediatric malignancy were 94.22%, 92.72%, 93.68% and 93.33% respectively. The sensitivities and specificities for initial staging of malignant lymphomas were ranged 70%-100% and 90.48%%-100% respectively. They ranged 80%-100% and 92%-100% respectively in STS. Conclusion: The study concluded that the PET/CT is the gold standard for noninvasive functional imaging in cardiovascular disease as well as in oncology. It has high diagnostic value in the assessment of myocardial viability in patients with known CAD. Technical developments in PET/CT scanning in cancer management may increase the precision of radiotherapy planning and thus improve tumor control and reduce treatment-related morbidity. The use of PET/CT in the management of pediatric malignancy is recommended to facilitate the sparing of normal structures and the escalation of dose.Further studies are recommended in cardiovascular patients for the incorporation of PET/CT into patient management is warranted.

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[Abaza A, El- ShanshouryH and El- Shanshoury G. (2017); THE EFFECTIVE VALUE OF PET/CT IN DIAGNOSING CARDIOVASCULAR DISEASE AND PEDIATRIC CANCER;A COMPARATIVE STUDY Int. J. of Adv. Res. 5 (Jan). 1771-1783] (ISSN 2320-5407). www.journalijar.com

Abaza A
Assistant Prof. of Safety and Prevention of Oncology in Radiation protection Department, Nuclear and Radiological Regulatory Authority, Cairo, Egypt.

DOI:

Article DOI: 10.21474/IJAR01/2947      
DOI URL: https://dx.doi.org/10.21474/IJAR01/2947

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