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Editorial |

Whole-Body Imaging With MRI or PET/CT:  The Future for Single-Modality Imaging in Oncology?

Lennart Blomqvist, MD, PhD; Michael R. Torkzad, MD
JAMA. 2003;290(24):3248-3249. doi:10.1001/jama.290.24.3248.
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Planning treatment for patients with cancer relies heavily on imaging information to establish tumor stage at presentation and to assess tumor response to treatment. It is also becoming increasingly desirable to define precisely the tumor target to deliver various forms of local treatment as accurately as possible. Because different imaging modalities have different inherent soft tissue contrast properties, use of several imaging modalities in a stepwise approach is common.

Computed tomography (CT) is the most commonly used technology in the evaluation of patients with cancer. Advances in technology of spiral CT with multiple detectors has significantly improved its efficacy and allows for rapid image acquisition of large parts of the body with thin slices during a single breath hold and, if desired also for whole-body scanning. However, the soft tissue contrast properties of CT for tumor staging are limited in terms of tumor delineation and metastases detection, even when intravenous contrast enhancement is used.1 The introduction of integrated positron emission tomography (PET) and CT (PET/CT) scanners is a potentially ideal solution to circumvent this limitation. This technology adds functional tumor information obtained through injection of radiolabeled metabolites, most notably the glucose analog tracer [18F]-fluorodeoxyglucose. Areas of increased metabolic uptake identified by PET can now be combined with superior spatial resolution of CT. The strength of this approach is further augmented if combined whole-body scanning can be performed in an acceptable imaging time.

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