TPS23x31-2|28.11.18-09:07 TPS23x31-2|28.11.18-09:07 TPS23x31-2|28.11.18-09:07 PET and PET/CT A Clinical Guide Third Edition EugeneC.Lin,MD DiagnosticandNuclearRadiologist VirginiaMasonMedicalCenter Seattle,Washington AbassAlavi,MD,PhD ProfessorandDirectorofResearchEducation DepartmentofRadiology PerelmanSchoolofMedicine UniversityofPennsylvania Philadelphia,Pennsylvania 335illustrations Thieme NewYork•Stuttgart•Delhi•RiodeJaneiro TPS23x31-2|28.11.18-09:07 ExecutiveEditor:WilliamLamsback Importantnote:Medicineisanever-changingscienceundergo- ManagingEditor:NikoleY.Connors ingcontinualdevelopment.Researchandclinicalexperienceare Director,EditorialServices:MaryJoCasey continuallyexpandingourknowledge,inparticularourknowl- ProductionEditor:NaamahSchwartz edgeofpropertreatmentanddrugtherapy.Insofarasthisbook InternationalProductionDirector:AndreasSchabert mentionsanydosageorapplication,readersmayrestassuredthat EditorialDirector:SueHodgson theauthors,editors,andpublishershavemadeeveryeffortto InternationalMarketingDirector:FionaHenderson ensurethatsuchreferencesareinaccordancewiththestateof InternationalSalesDirector:LouisaTurrell knowledgeatthetimeofproductionofthebook. 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TPS23x31-2|28.11.18-09:07 IwouldliketothankmycolleaguesatVirginiaMasonMedicalCenterforproviding anenvironmentwhichallowedmetowritethisbookandDrs.MarieLeeandPaulSicuro forhelpinobtainingmanyoftheimagesinthisbook.Myparentsinstilledinmealoveof learningandworkingwithresidentsandfellowsthroughoutmycareerhas inspiredmetocontinuallyseekoutnewknowledge. EugeneC.Lin IwishtodedicatethisbooktomymotherFatemehandmywifeJaneforsacrifices theyhavemadetomakemylifemostrewarding;Icannotthankthemenough fortheirenormousencouragementsallalong. AbassAlavi TPS23x31-2|28.11.18-09:07 PETandPET/CT|28.11.18-09:33 Contents Preface...................................................................... xi Contributors ............................................................... xiii PartIBasicScience 1 ThePhysicsofPET/CTScanners.......................................... 2 RuthE.Schmitz,AdamM.Alessio,andPaulE.Kinahan 2 TheBasicsof2-[F-18]Fluoro-2-deoxy-D-glucoseRadiochemistry andBiology ................................................................ 12 N.ScottMasonandEugeneC.Lin 3 TheRoleofGlucoseandFDGMetabolismintheInterpretation ofPETStudies.............................................................. 18 RonaldL.Korn,MelissaSingerPressman,andJohnMillstine PartIIClinicalBasics 4 PatientPreparation ....................................................... 28 EugeneC.Lin 5 StandardizedUptakeValue............................................... 36 EugeneC.LinandPaulE.Kinahan 6 QuantitativeWhole-BodyPET/CTImaging.............................. 42 SinaHoushmand,AliSalavati,AbassAlavi,andHabibZaidi 7 NormalVariantsandBenignFindings................................... 51 EugeneC.Lin 8 InterpretationofFDGPETStudies ....................................... 89 EugeneC.Lin 9 PET/CT...................................................................... 98 EugeneC.LinandPaulE.Kinahan 10 PET/MRI:IntroductiontoClinicalApplications ......................... 109 AliSalavati,SinaHoushmand,CoryDaignault,AbassAlavi,andDrewTorigian PartIIIOncologicApplications 11 OncologicalPETbyAnatomicRegion.................................... 128 EugeneC.Lin vii PETandPET/CT|28.11.18-09:33 Contents 12 TherapyResponse.......................................................... 142 SandipBasuandEugeneC.Lin 13 BrainNeoplasms ........................................................... 150 EugeneC.Lin 14 HeadandNeckCancer..................................................... 157 EugeneC.Lin 15 ThyroidCancer ............................................................. 169 EugeneC.Lin 16 ThoracicNeoplasms........................................................ 177 EugeneC.Lin 17 BreastCancer............................................................... 195 EugeneC.Lin 18 Gastric,Esophageal,andGastrointestinalStromalTumors............ 208 EugeneC.Lin 19 Lymphoma.................................................................. 220 EugeneC.Lin 20 Melanoma .................................................................. 232 EugeneC.Lin 21 HepatobiliaryTumors...................................................... 238 EugeneC.Lin 22 PancreaticCancer.......................................................... 245 EugeneC.Lin 23 GynecologicalTumors ..................................................... 253 EugeneC.Lin 24 UrologicalTumors.......................................................... 264 EugeneC.LinandEvanSirc 25 ColorectalCancer .......................................................... 280 EugeneC.Lin 26 MusculoskeletalTumors................................................... 291 EugeneC.Lin 27 18FSodiumFluoridePET/CTinBone...................................... 303 AlirezaRezaee,PoulHøilund-Carlsen,SørenHess,WernerLangsteger,andMohsenBeheshti viii PETandPET/CT|28.11.18-09:33 Contents 28 68Ga-BasedImagingTechniques ......................................... 311 PaoloCastellucci,CristinaNanni,andValentinaAmbrosini PartIVNononcologicApplications 29 PediatricPET/CT ........................................................... 324 M.BethMcCarville 30 PET/CTinRadiationTherapyPlanning................................... 331 SandipBasuandGuobinSong 31 FDG-PET/CTintheEvaluationofInfectionandInflammation......... 338 SandipBasu,AbassAlavi,andEugeneC.Lin 32 NeurologicalApplicationsofFluorodeoxyglucosePET ................ 352 EugeneC.Lin 33 NeurologicalApplicationsofNonfluorodeoxyglucoseTracers........ 360 MohsenKhosravi,AndrewB.Newberg,andAbassAlavi 34 CardiacPETandPET/CT................................................... 372 AmolTakalkar,UmeshSharma,andEugeneC.Lin Index........................................................................ 387 ix