Information for doctor

18F-FDG PET-MRI - a procedure of high diagnostic sensitivity for many diseases, including cancerous and non-cancerous diseases with increased glucose metabolism. Nuclear medicine provides a lot of valuable diagnostic tools in situations where traditional methods are insufficient for a correct diagnosis.

Indications for PET-MRI:

  • diagnostics of neurodegenerative diseases, dementia - eg. Alzheimer’s desease, differential diagnosis of fronto-temporal dementia (FTD) and Alzheimer’s desease (AD),
  • epileptic focus localization and diagnostics of diseases with interictal glucose hipometabolism,
  • diagnostics of ischemic heart disease (excluding the acute phase) and the assessment of myocardial viability,
  • assessment of tumor malignancy based on its metabolic activity and the degree of tracer accumulation,
  • detection of brain tumors with small diameter, eg. metastases from lung cancer (diameter of ~5 mm) à greater diagnostic sensitivity than CT or PET-CT,
  • imaging of head and neck tumors, eg. salivary glands, thyroid gland,
  • lung diseases diagnostics, including:
  • lung tumors and their metastases, sensitivity similar to PET-CT,
  • qualitative assessment of mediastinal tumors (mostly the detection and differentiation of fat components, hemorrhage, necrosis, cystic degeneration and evaluation of blood flow),
  • detection and staging of mesothelioma,
  • qualitative assessment and malignancy assessment of breast tumors (mostly with the use of an MRI or PET-MRI), imaging and evaluation of axillary lymph nodes,
  • assessment of inflammatory changes in sarcoidosis,
  • epigastric tumors with increased glucose metabolism,
  • abdominal tumors diagnosis, including:
  • liver - hepatocellular cancer, cholangiocarcinoma, liver metastases,
  • tumors of the bile duct - gallblader tumors, biliary tract cancer,
  • pancreatic cancer,
  • stomach, small intestine and other - stomach cancer, gastrointestinal stromal tumors,
  • colon - the glucose levels are hightened for most types of colon cancer,
  • urinary tract - localization and qualitative assessment of urological cancers, including kidney, renal pelvis, ureters, bladder and prostate cancer,
  • diagnostics, staging and relapse evaluation of gynecologic cancers in women in the pelvic region:
  • ovarian cancer,
  • endometrial cancer,
  • cervical cancer,
  • musculoskeletal system tumors:
  • cancer staging evaluation,
  • metastases and relapse diagnostics,
  • evalation of the response to treatment,
  • malignant melanoma - the scan allows to detect micrometastases (mostly subcutaneous, into bones, liver and brain), it is also used to assess the effectiveness of chemotherapy due to the possibility of metabolic evaluation of the tumors,
  • lymphomas and other hematological diseases - staging, evaluation of relapse/recurrence possibility, selecting the appropriate method of treatment and evaluation of the response to treatment,
  • localization of tumor primary origin,
  • inflammatory diseases such as sarcoidosis, vasculitis, localization of the source of inflammation.

Contraindications for MRI-PET scan and special precautions:

  • hypersensitivity to any of the active substances or any of the auxiliary substances in the radiopharmaceuticals - in case of hypersensitive response or anaphylaxis it is obligatory to stop the administration of the radiopharmaceutical substance and to administer the necessary drugs or give first aid,
  • individual analysis of the benefits and risks - it is necessary to carefully consider the administraton of the radiopharmaceuticals, and the diagnostic benefits must be more important that the potential risk of exposure to ionizing radiation,
  • uncontrolled diabetes - it is necessary to measure blood glucose levels before the procedure, as it has a significant influence on the accumulation of tracer in the body and on the sensitivity of the scan,
  • renal and liver failure - fluorodeoxyglucose (18F-FDG) is metabolized in the liver and excreted in the urine, so it is necessary to carefully consider administering the drug in patients with kidney diseases,
  • children and adolescents - indications for treatment and the risks to benefit ratio in this group of patients should be carefully considered,
  • pregnancy - the use of radiopharmaceuticals each time results in the fetus being exposed to radiation, so clinical indications for the procedure need to be carefully considered; the procedure should only be performed if it is absolutely necessary,
  • breastfeeding - it is best to perform the procedure after the period of breastfeeding, however, if it is not possible - the mother should not breastfeed for at least 12 hours and should not use the milk that was produced within that time.