Inflammation Diagnostics

How Does PET-CT Work in Inflammatory Diseases?

The basic principle of PET-CT for inflammation diagnostics is coupling radioactively labeled tracer substances to glucose molecules. This substance is injected into the patient's circulation and spreads throughout the organism via the bloodstream. As a result, cells that show an increased glucose turnover due to a high cell division rate accumulate the radioactively labeled sugar inside the cell.

Since, for example, degenerated or inflamed tissues go into uncontrolled division cycles due to mutation-related defects of regulatory proteins, tumor cells preferentially take up these weakly radioactive sugar molecules to meet their increased energy requirements.

Through complex radiation-physical interactions, radioactive beta decay produces positrons that interact with electrons at the site of the event. The mutual destruction (extinction) of the two elementary particles emits, i.e., emits two gamma photons in opposite directions, which can be registered by gamma cameras positioned in a ring around the patient.

Nowadays, positron emission tomography is usually performed in combination with computed tomography cross-sectional imaging, and the resulting images are subsequently superimposed. As a result, the pathological biochemical metabolic processes in the body can be localized with cellular precision.

Who Can Benefit from this Examination?

In principle, this examination is suitable for everyone. Sufficient thyroid and kidney function for the metabolism and excretion of the radiopharmaceuticals and contrast media is necessary. Diabetics should, in any case, point out their condition since changes in glucose metabolism can significantly influence the examination findings. Medications such as metformin or cortisone are paused in advance due to their effect on blood glucose levels. In the case of pregnant women and nursing mothers, an individual case-by-case assessment is carried out due to the harmful radiation exposure to the fruit or infant.

What Does a PET-CT for Inflammation Diagnosis Cost?

A PET-CT is one of the most expensive methods in imaging medicine. The costs for an entire-body examination in Germany amount to 1000-1500€. These enormous costs are justified by the excessive acquisition costs of PET devices and the cost-intensive production of radiopharmaceuticals. Statutory health insurance companies only cover these costs if the patient is treated as an inpatient.

The Procedure of the Examination

On the day of the examination, but at least twelve hours before the examination begins, the patient should not eat any food (including sugary sweets, chewing gum, sweet drinks, etc.). Blood glucose and insulin levels should be as low as possible for optimal examination results. This strict fasting requirement may be waived for diabetic patients in exceptional cases. To accelerate the excretion of the radioactive substances, sufficient fluid intake should be ensured before and after the examination.

Before the examination, a radioactively labeled substance is administered via the vein. This so-called tracer is distributed through the bloodstream during a subsequent rest period and accumulates in metabolically active tissue. To produce an optimal contrast in the imaging through maximum accumulation, this exposure time is between 60 and 90 minutes. During this waiting period, it is essential to avoid any movement and lie as still as possible to minimize the uptake of labeled glucose into muscle tissue. Therefore, if necessary, a sedative can be administered if the patient is very nervous. The actual recording of the image material takes place afterward and takes another 30 to 60 minutes. During this time, care should be taken to ensure that the patient is lying comfortably to avoid blurring the images.

Which Doctors and Clinics Are Specialized in Inflammation Diagnostics?

Every patient who needs a doctor wants the best medical care. Therefore, the patient is wondering where to find the best clinic. As this question cannot be answered objectively, and a reliable doctor would never claim to be the best one, we can only rely on a doctor's experience.

We will help you find an expert for your condition. All listed physicians and clinics have been reviewed by us for their outstanding specialization in inflammation diagnostics and are awaiting your inquiry or request for treatment.

Literature References

• Gotthardt et al., Der Beitrag der 18 FDG-PET in der Entzündnungsdiagnostik erschienen in Der Nuklearmediziner 02/2017
• www.nuklearmedizin.de/leistungen/leitlinien/html/tumo_pet_ct.php
• nuklear.med.uni-rostock.de/patienten-zuweiser/pet/ct-zentrum/pet/ct-untersuchungen/entzuendungssuche