Since the high-end molecular imaging equipment introduced by the Huashan-Fifth Hospital-Minhang Medical Consortium PET/CT Center was officially put into use in July 2023, more than 300 patient examinations have been completed, providing strong support for accurate clinical diagnosis and treatment, and at the same time, many physical examination patients can experience the convenience, speed and benefit from the high-end PET/CT examination at their doorstep. Recently, 60-year-old Uncle Yin was hospitalized in the endocrinology department of Shanghai Fifth People's Hospital due to poor diabetic blood sugar control.
On the day of the examination, the nuclear medicine doctor inquired about Mr. Yin's medical history in detail and learned that he was generally in good condition, with no very obvious clinical signs and symptoms, no family history of tumor, surgery and other past medical history, and then PET/CT examination. But when the PET/CT scan results were transmitted to the doctor's office, the doctor was surprised when he read the images carefully. In the absence of obvious symptoms, doctors found a hypermetabolic mass lesion in his lungs and stomach, both of which were considered neoplastic. The doctor's report clearly points out these two lesions and other visible lesions, and gives corresponding diagnostic opinions and recommendations.
Therefore, after getting the PET/CT report, Uncle Yin was immediately transferred to the Department of Thoracic Surgery of the Fifth Hospital for treatment and surgery, and was pathologically diagnosed with lung adenocarcinoma after surgery. After recovering for a period of time after the operation, he went to the hospital again for surgery for gastric tumors, and the pathological diagnosis was gastric stromal tumor. PET/CT is a kind of imaging examination, and the metabolic imaging of whole-body PET, the anatomical information of CT and the fusion image results of PET/CT can be obtained at the same time through one examination, so as to achieve the imaging effect of "1+1>2". At present, 18F-FDG PET/CT examination is the most commonly used in clinical practice, which can be used to assess the systemic tumor burden of patients, and has important value in early screening, early diagnosis, benign and malignant differentiation, malignant tumor staging, finding the primary lesion for patients with unexplained fever or metastatic tumors with unknown primary focus, evaluating the efficacy, and positioning the target of lesion puncture. Mr. Yin's whole body examination through PET/CT showed that the tumor was found before the relevant clinical symptoms appeared, whether it was a lung tumor or a gastric tumor, so that he could get the best chance of surgical treatment and achieve the purpose of early diagnosis and early treatment. In addition, a PET/CT examination found a tumor lesion in the chest and abdomen at the same time, avoiding the missed diagnosis of another site due to only one part of the examination, which is also the advantage of PET/CT, that is, passing. This fully reflects the important role of PET/CT examination in the systemic screening and differential diagnosis of tumors, and the detection of repeat tumors.
Clinical indications for PET/CT include:
1. Differential diagnosis of benign and malignant lesions;
2. Detect metastatic lesions and explore the primary lesions;
3. Determine the stage of malignancy;
4. Efficacy monitoring and follow-up evaluation of malignant tumor treatment;
5. Tumor exploration for high-risk groups and people with elevated tumor markers;
6. Diagnosis of cardiac and neurological-related diseases;
7. Identification of diagnostic puncture targets for biopsy;
8. Guide the formulation of radiotherapy plan;
9. Patients with fever of unknown cause, difficult and complex cases, and other conditions.
PET/CT can also be used for physical examination and screening of high-risk cancer groups
1. Those who find suspicious lesions or abnormal tumor indicators of unknown cause during physical examination, and still indicate abnormalities after follow-up or treatment.
2. Have a family history of cancer.
3. History of chronic diseases with risk of malignant transformation, such as liver cirrhosis, atrophic gastritis, multiple intestinal polyps, etc.
4. Those who have bad lifestyle habits, have obvious discomfort recently, and are suspected of having a tumor risk.
PET/CT examination for the above patients can detect the lesions in the embryonic state at an early stage, so as to achieve the purpose of early detection, early treatment and early rehabilitation.
Editor: Chen Meiling
Contributed by: District Health Commission
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