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1 PET ( TIAN Mei )

2 PET 100 PET

3 PET PET PET

4 PET

5 Positron Emission Tomography (PET) PET Positron Emission Tomography CT

6 PET FDG

7 Glucose and 18 F-FDG 18 F-FDGFDG CH3OH O CH3OH O OH OH OH OH OH OH OH 18 F *FDG 18F-FDG D- 18-F

8 FDG

9 PET PET 110

10 PET

11 Positron emitters for clinical PET scanning Isotope Half-life Fluorine: 18 F Carbon: 11 C Oxygen: 15 O Nitrogen: 13 N 110 min 20 min 2 min 10 min

12 Biochemical and physiological processes visualized by PET Mechanism PET tracers Glucose utilization FDG Phospholipid metabolism Choline Amino acid transport Methionine and metabolism FAMT Proliferation Thymidine, FLT Apoptosis Annexin V Blood flow H 2 O Hypoxia FMISO Bone Metabolism Sodium fluoride

13 Mechanism of PET tracers Glucose utilization Phospholipid metabolism Amino acid transport and metabolism Proliferation Apoptosis Blood flow Hypoxia Bone Metabolism

14 Glucose utilization FDG Cellular uptake of FDG through glucose transporters and phosphorylation by hexokinase Widespread established clinical usages including staging, assessment of response, and detection of recurrence

15 Phospholipid metabolism 11 C-Choline, 18 F-Choline Cellular uptake of labeled choline through specific receptors and phosphorylation by choline kinase. Endogenous choline is subsequently involved in synthesis of membrane phospholipids. Evaluation of prostate tumors and breast cancer

16 Brain Tumor A 58-year-old male with glioblastoma in the right frontal lobe. (A) MRI image showed a ring-enhanced tumor in the right frontal lobe. (B) 11 C- Choline PET demonstrated high 11 C-Choline uptake (SUV = 4.4). (C) FDG-PET showed significant high accumulation (SUV = 10.1).

17 Phospholipid metabolism 11 C-acetate Mechanism of uptake incompletedly understood. Thought to be involved in synthesis of phosphatidylcholine and other lipids Evaluation of prostate tumors and breast cancer

18 Advanced prostate cancer 18 F-FDG 11 C-acetate Multiple osseous metastases (arrows) were better visualized with 11 C- acetate PET than with 18 F-FDG PET.

19 PET PET PET

20 PET PET X CT MRI PET PET

21 PET CT PET

22 PET PET

23 FDG-PET

24 Normal FDG PET Image

25 Normal FDG PET Image

26 Lung cancer

27 FDG FDG

28

29

30

31

32 FDG-PET 2

33 FDG-PET BAC) 10mm FDG CT FDG

34 PET FDG-PET PET FDG-PET

35 PET FDG-PET PET FDG-PET

36

37

38 CHOP RI CD20 (Y) 90 CD20

39 FDG-PET MALT T Castlemen s disease CT MRI FDG

40 FDG-PET 5mm FDG BAC)

41 PET

42 PET CT mm

43 PET PET PET

44 C T + P E T

45 CT PET

46 CT-PET

47 PET RI CT 100g MRI 10g RI g g PET (Molecular Imaging) cf: CT mm

48

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