Cancer has maximum healing chances if it is detected in time, stresses all doctors, but equally important is a correct diagnosis that will determine the type of malignant tumor and its aggressiveness.
Depending on this information, oncologists can recommend patients with personalized therapies that are an extra chance to overcome malignancies. Technology is an important component of the diagnostic protocol, and with the help of state-of-the-art devices, multidisciplinary teams of oncologists, nuclearians, radiologists, radiotherapists, surgeons and anatomopathologists can take the best therapeutic decisions.
From the cancer diagnostic and staging protocol, as well as the monitoring of the results of the therapy, PET / CT, a latest generation imaging method, available from July and at the Onco Card Hospital in Brasov, in partnership with the Neolife Medical Center, is part of it.
"PET / CT is a cumulation of two devices in one. PET means positron emission tomography, CT means computer tomography. And here, in one device, there are two different diagnostic ways that help diagnose, stage and monitor oncological disease. If the CT shows anatomical affection, the PET provides functional information about the metabolic activity of the tumor. And for an oncological diagnosis it is very important to establish the aggression of the tumor. However, there are cases where we find metastases and we do not know where they started, and here PET / CT helps: through a simple scan, from the top of the head to the upper third of the thigh, PET / CT can provide information on tumors that have generated metastases, "describes the benefits of this research, Dr. Claudia Buzumurga, coordinator of the new Department of Nuclear Medicine at Onco Card Hospital, a physician with more than 20 years of experience and vice president of the Romanian Society of Nuclear Medicine and Imaging molecular.
Before scanning the body, specialists inject fluorosurfactant-labeled glucose into patients – in most cases, the PET / CT exam is performed with 18F-FDG. It is known that malignant tumors have increased metabolism and absorb faster glucose. Thus, the radiolabelled one gets faster into malignant tissues that can be highlighted during PET / CT scanning. The radiopharmaceutical dose administered is calculated based on body weight, and scanning is performed 60-75 minutes after injection. The investigation takes 20 minutes and can provide information about the tumor, metastasis, relapse, but also about the progress of the treatment and the ability of the body to respond to it.
"Patients are not allowed to eat the day before 18 o'clock, they do not have to make an effort, they are not allowed to drink coffee, they are not allowed to eat sweets, to stay in the cold. However, in the morning, when they come, their blood sugar is measured and weighed, because glucose-labeled glucose doses are given in terms of body weight. It is also known from the beginning if a patient is diabetic or not, what kind of medication takes, etc. We do not do PET / CT if the blood sugar is higher than 200, "completes the nuclear medicine expert.
Here are the types of cancer most commonly used in PET / CT for diagnosis and monitoring:
"Among the indications are ENT spheres (head, neck), thyroid, thymic, breast, lung, colorectal, gastric, ovarian, uterine, anal, vulvar, penile, malignant pleural malignancy, lymphoma, myeloma, melanoma long list of indications. The most common uses are in our country in breast, lung, and lymphoma cancers. At any of these cancers, you can also analyze metastasis. In children, it is used in soft tissue sarcomas, lymphomas, osteosarcomas, malignant liver tumors, malignant kidney tumors, etc. It does not matter the stage of the disease, we just have to fit into the list of indications, "says doctor Claudia Buzumurga of the list of oncological conditions in which PET / CT applies.
Investigations may be repeated at the recommendation of physicians. In addition, patients need to stay calm about the radioactive substance.
"We always look at the manipulation of rays of any kind, and the benefits to the information that our investigations give us. We balance the radiation we have done and the fact that we receive information that helps us to treat patients correctly. In monitoring, we can make PET / CT a few weeks / months according to the protocols. The radioactive substance has a half-life of 2 hours, is excreted via urine, faeces through the skin. The dose administered is not high. We always advise the patient not to stay in the same room with the family until the next day as a protection for others. In our department, according to the procedures, patients follow a certain circuit so that the irradiation of patients and medical staff is minimal, "concludes Dr. Claudia Buzumurga, primary medicine physician.
The first PET / CT was introduced in the United States in 2001 and at the end of 2009 there were 350 functional devices in Europe. In 2010, there were already over 500 installed scanners. In Romania, however, the number of PET / CT equipment was 10 times below the European average by the end of 2015, which predicts 1 PET / CT per 1 million inhabitants. In 2019, there are 9 functional PET / CT machines in Romania, out of which 3 in Bucharest. 3 of the 9 scanners available in Romania are located in NEOLIFE Medical Centers in Bucharest, Iasi, and now in Brasov, on the Onco Card Hospital. For the time being, the investigation is available counter-cost in Braşov, and will soon enter into settlement as many oncological medical services within the Onco Card.