While Positron Emission Tomography (PET) and Computerized Tomography (CT) are the stalwarts of imaging modalities, each has its limitations.

Combining the two technologies into one scanner, however, improves efficiency and accuracy and leads to improved patient care.

MUSC is among the first hospitals in South Carolina to acquire this latest generation of PET/CT scanning technology, which not only identifies the presence of cancer but also can gauge the level to which the disease has spread to surrounding tissue.

By fusing the metabolic information of a PET scan with the anatomical information of a CT scan into a single image, the PET/CT scanner can precisely locate cancer and enhance treatment recommendations.

“PET alone is good, but it doesn’t show exactly where the uptake is within the patient,” says Philip Costello, M.D., chairman of the MUSC Department of Radiology. “The strength of the PET/CT is that we can superimpose the two images with precision. Not only can you see where the metabolic tumor is, but you can identify its precise anatomic location. PET/CT improves our specificity and sensitivity in staging malignant disease.”

The newly installed technology will have widespread use at MUSC in detecting and, more importantly, in staging lung, colorectal, esophageal, melanoma and other cancers. Dr. Costello also sees potential for numerous other applications, including helping map out cardiovascular disease and in the planning of revascularization procedures.

A recent article in Radiology concluded that, “PET/CT is a more accurate test than either of its individual components and is probably also better than side-by-side viewing of images from both modalities.”

Studies have demonstrated that the scanner is effective in the staging of non-small cell lung cancer, recurrent colorectal cancer and malignant lymphoma.

Dr. Costello says the machine can give physicians a roadmap of sorts for tumor treatment. It can be helpful for planning radiation therapy and in deciding where to administer the largest dose.

David Davison, nuclear clinical coordinator at MUSC, said the scanner is much faster than traditional methods. While acquiring separate PET and CT scans can take an hour or more, the combined scanner can provide more accurate images in about 20 minutes. “That’s a huge difference,” Davison says, “especially if you are in pain.”

Additionally, the PET/CT scanner can be paired with a video gating device that compensates for movement caused by a patient's breathing. This synchronized acquisition data can then be utilized in radiation therapy planning.

Dr. Costello, who has experience working with similar PET/CT scanners at other hospitals, says the availability of more precise images will allow for earlier evaluations of treatments and their effectiveness. “Joining these two images provides the tools for better patient care.”