Applications of positron emission tomography/computed tomography image fusion in clinical positron emission tomography - Clinical use, interpretation methods, diagnostic improvements

Positron emission tomography (PET)/computed tomography (CT) scanners with combined dedicated high performance PET and CT scanners have been introduced recently in PET imaging. Oncological imaging with fluorodeoxyglucose (FDG) is currently the dominant application of PET. The addition of CT to PET offers many advantages, including obtaining a fast and relatively low-noise transmission scan, shortening the duration of the examination, adding precise anatomical information to FDG imaging, and providing additional diagnostic information. However, the use of CT for attenuation correction can lead to some artifacts that need to be considered when interpreting a PET/CT study: quantitative measurements may be altered, high density IV and oral and metallic objects may produce artifacts, and the registration of PET and CT may occasionally be suboptimal. Areas where using PET/CT offers particular potential advantages include the head and neck region, abdomen, and pelvis. Even in the thorax, PET/CT offers some advantages. Although clinical data evaluating the added value of PET/CT over PET are presently limited, preliminary results are very encouraging. More studies are warranted to clearly define the clinical impact of PET/CT over PET; however, it is clear this dedicated fusion technology will be very important for patient imaging in the coming years.