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PET/CT and Respiratory Gating


The Regional Cancer Center is home to one of the newest cancer-fighting tools available anywhere: The Discovery LSTM from GE Medical Systems, which uses a two-in-one system called PET/CT. It is the fastest and most sophisticated technology on the market to determine if a patient has cancer, if it has spread, whether a particular treatment plan is working, or if there has been a recurrence. It provides the best of both worlds: CT scanning (computed tomography) which creates excellent images of anatomic structures, and PET scanning (positron emission tomography) which depicts cellular function. When combined, PET/CT scanning vastly improves identification and staging of tumors with pinpoint determination of location. And by targeting a tumor so precisely, it allows the greatest dose of radiation possible to the smallest volume of tissue. It may also make some biopsies and surgeries unnecessary.

It is especially useful in assessing tumors of the brain, lung, colon, breast, head, neck and esophagus, as well as melanoma, the deadliest skin cancer.

The PET/CT system assists radiation oncologists at The Cancer Center in treating cancerous tumors more precisely because it works with the Medical Center's GE Varian treatment planning and delivery system. Not only does the PET/CT scanning system provide increased accuracy but it also helps determine in mid-course whether treatment is working. If not, treatment can be revised halfway through the course of therapy, thus increasing the patient's chances for treatment success and improving quality of life.

PET/CT scanning system: A PET scan (left shows biochemical action; a CT scan (center) maps anatomical structure. Combining the two (right) helps doctors understand the extent and exact location of the cancer. This helps them develop exceptionally accurate treatment plans.

Respiratory Gating and PET/CT
The simple act of breathing significantly impacts the way lung cancers and upper abdominal malignancies are treated. As the lungs expand and contract while inhaling and exhaling, lung tumors move and, even change shape, making precise targeting of radiation beams difficult. Holy Name Medical Center's Regional Cancer Center is among an elite cluster of Medical Centers incorporating two breakthrough technologies (PET/CT and respiratory gating) to treat these types of cancers.

How it works.
With the radiation beam is activated in synchronization with a patient's respiratory pattern, it targets the tumor only when it is in the optimal position and prevents the radiation beam to hit healthy tissues. Using the data from respiratory-gated PET/CT, Holy Name physicians are able to treat these individuals with potentially effective radiation doses, minimizing the chances of damaging vital organs, such as the heart, lungs, spine and kidneys. Holy Name was the first Medical Center anywhere to practice respiratory-gated PET/CT fusion for planning respiratory-gated radiation therapy on individuals with lung cancer, tumors on or near the heart; and gastric, pancreatic and hepatic tumors.

By using these scans as the basis for the treatment plan and incorporating Varian's RPM respiratory gating system and GE's Advantage 4D gating application to track motion within the patient's breathing cycle, treatment accuracy can be significantly enhanced.