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PET-CT (Positron Emission Tomography – Computed Tomography) leads us into a new era of molecular imaging. It combines the valuable and unique information of living cancer cells of a mass that PET gives us, with the imaging of the location, shape and dimensions of the mass that CT gives us. It really sheds light on diagnosis, more accurate treatment planning and more accurate control of the response to cancer treatment and is an integral part of modern oncology.

We have known PET-CT for about 20 years now. How has it evolved?

The evolution of PET-CT is directly related to technological progress, the integration of artificial intelligence, the discovery of new radiopharmaceuticals that target certain types of cancer. It thus contributes significantly to achieving personalized medical precision.

Technology evolution in PET-CT

PET-CT has evolved with new digital imaging systems that are at least twice as sensitive as the older ones. This means that we can detect very small lesions measuring a few millimeters and break the one-centimeter barrier. We can reduce the imaging time by even 50% so that the examination is more easily tolerated by the patient, who is often tired, in pain, afraid, or claustrophobic. At the same time, we can significantly reduce the dose of radiopharmaceutical administered and therefore the irradiation dose for the patient, without compromising image quality.

How does artificial intelligence help us in PET/CT?

PET-CT incorporates and utilizes artificial intelligence on many levels:

• improving image quality, even with a lower dose of drug
• faster and better image processing protocols that ensure the detection of small foci
• automatic AI-assisted correction of respiratory movements that may affect the accurate localization of a lesion
• automatic, faster detection and quantitative measurement of pathological foci in whole-body imaging. Artificial intelligence does not replace the knowledge and experience of the doctor, but it assists him both in the quality and speed of diagnosis

What are the new radiopharmaceuticals and where do we use them?

In PET-CT, our main radiopharmaceutical is FDG, a form of glucose that enters cancer cells in a greater “quantity” than normal cells, as the former have greater energy needs to multiply quickly. In some cases where FDG does not have satisfactory results, we now have at our disposal newer special targeted radiopharmaceuticals. That is, drugs that show distinct characteristics of certain types of cancer.

For example:

• in prostate cancer, F18-PSMA, which exceeds the diagnostic accuracy of standard imaging, both for initial staging and for detecting disease recurrence at very low PSA levels.
• in neuroendocrine cancers, Ga68 DOTATOC, which targets somatostatin receptors for precise staging and monitoring of treatment.
• in brain tumors, 18F FET and 18F DOPA, which study amino acid metabolism and, in combination with MRI, provide additional information on biology, tumor extent and possible recurrence.

In addition, we should emphasize the importance of PET-CT with new radiopharmaceuticals in completely targeted therapies with radiopeptides for prostate cancer and neuroendocrine tumors, where we can treat what we see and also see what we treat.

In a few words, what is the benefit for the patient?

• Early and more accurate diagnosis
• Personalized treatment
• More accurate and reliable monitoring

The Athens Medical Group, always investing in cutting-edge technologies, equips the new PET-CT departments at the Athens Medical Center and the International Oncology Center at the Inter-Balkan Medical Center of Thessaloniki with two state-of-the-art digital PET/CT systems of the latest generation with extremely high sensitivity and scanning speed, with integrated artificial intelligence algorithms and the ability to detect foci of just a few millimeters, ensuring oncology patient all the advantages of PET technology.