Background Information:

What are the other Names for the Procedure?

• PET/CT Scan

What is PET/CT Scan radiology procedure? (General Explanation)

• Positron Emission Tomography - Computed Tomography (PET/CT) Scan is a type of nuclear medicine imaging. Nuclear medicine uses very small amounts of radioactive material to diagnose and treat various kinds of diseases such as heart diseases, cancers, endocrinal, gastrointestinal, and neurological disorders
• A PET scan provides information on how organs and tissues are functioning. It does so by measuring the blood flow, metabolism, and oxygen use of the tissues
• It is a non-invasive procedure that provides details about molecular activity in the body and thus helps detect diseases during their early stages
• PET scan is often used in combination with CT scan to provide accurate diagnosis. In image fusion, images are taken from nuclear medicine and superimposed with CT or MRI mode, to produce special images to get more information and enable an accurate diagnosis

What part of the Body does the Procedure involve?

The Positron Emission Tomography - Computed Tomography (PET/CT) Scan may involve various organs of the body depending on the procedure being performed.

Why is the PET/CT Scan radiology procedure Performed?

Positron Emission Tomography - Computed Tomography (PET/CT) Scan procedure is used to diagnose the following conditions:

• Cancer diagnosis and treatment:
  • To detect the presence of cancer
  • To determine a treatment plan for cancer
  • To determine metastasis of the cancer (to where it has spread)
  • To determine how aggressive the cancer is
  • To determine recurrence of cancer after treatment           
• To diagnose brain abnormalities
• It is also used check blood flow to the heart muscle and to determine how well the heart is functioning
• PET scan can also be used after myocardial infarction to determine the extent of damage

What is the Equipment used? (Description of Equipment)

The following equipment is used during a PET/CT Scan procedure:

• PET scanner:
  • The PET scanner looks like an MRI or a CT scan unit
  • It is a large machine with a round hole and examination table in the middle
  • The patient lies on an examination table and the table moves in and out of the round hole 
• CT scan:
  • The CT scanner looks like a big box with a hole inside
  • The examination table on which the patient lies down, which slides in and out of the hole
  • X-ray tube and electronic X-ray detectors rotate around the patient
  • Images are taken from a computer

What are the Recent Advances in the Procedure?

There have been no recent advances in the PET/CT Scan procedure.

What is the Cost of performing the PET/CT Scan radiology procedure?

The cost of PET/CT Scan procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary. 

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding PET/CT Scan procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1255942/ (accessed on 03/10/2015)

http://www.ncbi.nlm.nih.gov/pubmed/14736831 (accessed on 03/10/2015)

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004284/ (accessed on 03/10/2015)

Prior to PET/CT Scan radiology procedure:

How does the PET/CT Scan radiology procedure work?

• PET scan uses radioactive material that is sent to the organ being examined through injection into the bloodstream, inhalation, or by swallowing it
• This radioactive material accumulates in the organ being examined. The accumulation of the radioactive material is directly proportional to the metabolic activity of the tissues, oxygen use, and blood flow in that organ
• Once the radioactive material accumulates in the targeted organ, it emits energy in the form of gamma rays, which is detected by a computer and used to create images of the structure and function of the targeted organ
• Nuclear medicine is different from other imaging techniques, because it provides images based on the physiological processes of the organ

How is the PET/CT Scan radiology procedure Performed?

A Positron Emission Tomography - Computed Tomography (PET/CT) Scan is performed in the following manner:

• The patient is positioned on the examination table in a supine position
• An IV line is inserted into the patient’s arm vein
• Radiotracer material is used during the procedure, which is either injected to the IV line, swallowed, or inhaled, based on the procedure being performed
• The patient has to wait until all the radiotracer material reaches the target organ, which takes about an hour. Generally, the patient is asked to avoid any movement or talking during this period
• Once the radiotracer material reaches the target organ, the patient is taken to the PET/Scan machine
• During the scan, the patient is asked to avoid any movement as it may compromise the image quality
• The required images are taken using the CT scan, followed by a PET scan
• Depending on the procedure being performed, patient may or may not need additional imaging
• After the examination is completed, the patient may be asked to wait while the radiology technologist checks to see if all the necessary images are taken
• After the procedure is complete, the IV line is removed

Where is the Procedure Performed?

The PET/CT Scan procedure is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

A radiology technologist performs the procedure under the supervision of a radiologist.

How long will the Procedure take?

• A PET/CT scan procedure takes about 30 minutes to complete
• In certain examinations, such as PET scan for heart disease that may require additional images, this procedure may take several hours

Who interprets the Result?

The radiologist interprets the results of a PET/CT Scan procedure.

What Preparations are needed, prior to the Procedure?

The following preparations are needed prior to a PET/CT scan procedure:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material or radiotracers, which may be used in the procedure
• It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the X-ray
• Women should notify the physician, if they are pregnant or breastfeeding their child; as many such procedures may not be performed on pregnant women
• Depending on the procedure adopted, the patient may be asked for certain bowel or bladder preparations, before the preparation sessions
• The patient may be asked to avoid eating or drinking, several hours before the test

What is the Consent Process before the Procedure?

A physician will request your consent for Positron Emission Tomography - Computed Tomography (PET/CT) Scan procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent. 

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the PET/CT Scan procedure:

• The scan is painless, cheap, and a noninvasive procedure
• It may provide better and precise information than exploratory surgery, in some cases
• The PET/CT Scan relies on the physiologic processes of the tissues and thus provides information about function and anatomical structure of the target organ
• The PET/CT Scan is very useful in detecting many abnormalities in the organs, as it provides information at the cellular level
• The image quality using the combined procedure is very high

Following are the risks of the PET/CT Scan procedure:

• There are very small chances of developing cancer due to excess radiation, as radioactive material used during the procedure is very minimal
• Radiotracer and contrast materials used in the procedure may cause severe allergic reactions in some patients
• The procedure may not be performed on pregnant or breastfeeding women

What are the Limitations of the PET/CT Scan radiology procedure?

Following are the limitations of the PET/CT Scan procedure:

• Some obese individuals may not fit into the scanner
• Patients who are claustrophobic may find it uncomfortable going through the procedure
• PET scan by itself may not provide as good of resolution as CT or MRI (but a PET/CT Scan can provide a higher quality of images)
• Nuclear medicine could be time-consuming, as it may take several hours or days for the radiotracer to accumulate in the target organ
• Radiotracer material decays very quickly; thus, it is very important to capture images during the correct time period

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is a Positron Emission Tomography - Computed Tomography (PET/CT) Scan procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the PET/CT Scan radiology procedure:

What is to be expected during the PET/CT Scan radiology procedure?

The following may be expected during a PET/CT Scan procedure:

• The patient may feel a slight pain when the IV line is inserted into the patient’s vein
• If the radiotracer material is injected through the IV line, patients may feel a cold sensation in their arms
• Swallowed radiotracer material has no taste
• The patient is asked to remain still during the procedure
• Normal activities may be resumed after the procedure

What kind of Anesthesia is given, during the Procedure?

No anesthesia is used during the PET/CT Scan procedure.

How much Blood will you lose, during the Procedure?

Since the scan is non-invasive, no blood is lost during the procedure.

What are the possible Risks and Complications during the PET/CT Scan radiology procedure?

Radiotracer material or contrast material used during the PET/CT Scan procedure may cause allergic reactions in certain patient groups.

What Post-Operative Care is needed at the Healthcare Facility after the PET/CT Scan radiology procedure?

No specific post-operative care is needed at the healthcare facility after the PET/CT Scan procedure.

After the PET/CT Scan radiology procedure:

What is to be expected after the PET/CT Scan radiology procedure?

• Patients may resume their normal activities immediately after the PET/CT scan procedure
• Small amount of radiotracer material stays in patient’s body after the procedure and gets eliminated over time through urine and stool. Patients are advised to drink plenty of water to help eliminate the radioactive materials faster

When do you need to call your Physician?

If patients develop redness, warmth, pain, or swelling at the site of IV injection accompanied with high fever after the PET/CT Scan procedure, they should call their physician.

What Post-Operative Care is needed at Home after the PET/CT Scan radiology procedure?

• No specific post-operative care is needed at home after the PET/CT Scan procedure
• Patients are asked to drink plenty of water for quicker elimination of the radioactive material remaining in their body

How long does it normally take to fully recover, from the Procedure?

There is no recovery time involved; patients may resume their normal activities immediately after the scan procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The PET/CT Scan procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the PET/CT Scan procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the PET/CT Scan radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• Healthcare providers, physicians, and radiologists, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before Positron Emission Tomography - Computed Tomography (PET/CT) Scan procedure is performed.