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first_img Image courtesy of Imago Systems Arthur Agatston explains the history of CT calcium scoring Video Player is loading.Play VideoPlayMuteCurrent Time 0:00/Duration 9:54Loaded: 1.67%Stream Type LIVESeek to live, currently playing liveLIVERemaining Time -9:54 Playback Rate1xChaptersChaptersDescriptionsdescriptions off, selectedCaptionscaptions settings, opens captions settings dialogcaptions off, selectedAudio Trackdefault, selectedFullscreenThis is a modal window.Beginning of dialog window. 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Related Content News | Radiopharmaceuticals and Tracers | August 02, 2019 ASRT Supports Radiopharmaceutical Reimbursement Bill The American Society of Radiologic Technologists (ASRT) announced its support for House Resolution (HR) 3772, a measure… read more Video Player is loading.Cynthia McCollough explains new advances in CT technologyPlay VideoPlayMuteCurrent Time 0:00/Duration 13:56Loaded: 1.17%Stream Type LIVESeek to live, currently playing liveLIVERemaining Time -13:56 Playback Rate1xChaptersChaptersDescriptionsdescriptions off, selectedCaptionscaptions settings, opens captions settings dialogcaptions off, selectedAudio Trackdefault, selectedFullscreenThis is a modal window.Beginning of dialog window. Escape will cancel and close the window.TextColorWhiteBlackRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentBackgroundColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentTransparentWindowColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyTransparentSemi-TransparentOpaqueFont Size50%75%100%125%150%175%200%300%400%Text Edge StyleNoneRaisedDepressedUniformDropshadowFont FamilyProportional Sans-SerifMonospace Sans-SerifProportional SerifMonospace SerifCasualScriptSmall CapsReset restore all settings to the default valuesDoneClose Modal DialogEnd of dialog window.Close Modal DialogThis is a modal window. This modal can be closed by pressing the Escape key or activating the close button. The top piece of content in July was a video interview explaining how Princess Margaret Cancer Center is using machine learning to create automated treatment plans. This was a hot topic at the American Association of Physicists in Medicine (AAPM) 2019 meeting in July.  News | Artificial Intelligence | August 13, 2019 Artificial Intelligence Could Yield More Accurate Breast Cancer Diagnoses University of California Los Angeles (UCLA) researchers have developed an artificial intelligence (AI) system that… read more News | Interventional Radiology | July 31, 2019 International Multidisciplinary Group Publishes Recommendations for Personalized HCC Treatment With Y90 TheraSphere New consensus recommendations for personalized treatment for hepatocellular carcinoma (HCC) with BTG’s TheraSphere have… read more Feature | August 05, 2019 | Dave Fornell, Editor Most Popular Radiology and Radiotherapy Topics in July 2019 August 5, 2019 — Here is the list of the most popular content on the Imaging Technology New (ITN) magazine website fr read more News | PET-CT | August 15, 2019 United Imaging Announces First U.S. Clinical Installation of uExplorer Total-body PET/CT United Imaging announced that its uExplorer total-body positron emission tomography/computed tomography (PET/CT) system… read more Videos | Computed Tomography (CT) | July 30, 2019 VIDEO: New Advances in CT Imaging Technology Cynthia McColl… read more This image shows focal uptake suspicious for malignancy in the posterior breast near the chest wall.Positron emission mammography (PEM) is an imaging technique designed to provide metabolic visualization of lesions in the breast tissue. The Naviscan high-resolution PEM system is a dual-detector system consisting of two flat, high-resolution detector heads using lutetium yttrium oxyorthosilicate in a 2 x 2 x 13 mm size. The detectors are mounted inside mammogram compression paddles with a 17 x 24 cm field of view.  The paddles can be rotated to optimize imaging to match images acquired in standard mammograms.  This allows for direct comparison with mammogram images.Mammography uses X-rays through the breast tissue to make an image. Because of this, dense breast tissue presents a problem for diagnosis. A significant amount of the population has dense breasts. With PEM imaging, it does not matter if a woman has dense breasts or what stage she is in her menstrual cycle. Additionally, PEM is set for 10 to 15 pounds of pressure, which is significantly less than the 35 to 45 pounds of pressure required to obtain an adequate mammogram image.The lesion size that is detectable with the PEM unit is as small as 1.6 mm, or the width of a grain of rice. Having the detectors so close to the breast tissue allows for an in-plane spatial resolution of 1.5 mm full width half maximum. This compares quite favorably to commercially available whole body positron emission tomography (PET) scanners that have a 4.2 to 6.5 mm axial resolution. Spatial resolution in a whole body PET scanner is also decreased due to respiratory motion, whereas with the breast immobilized in the PEM unit, there is no motion.Mammography will always be the first line in detection of breast cancer. However, when mammography detects an abnormality, the patient then moves on to ultrasound and magnetic resonance imaging (MRI). A major disadvantage of ultrasound and MRI is their low specificity. Studies have shown that both the sensitivity and specificity of images produced by the Naviscan PEM scanner exceeds 90 percent. As a result, surgeons can more accurately stage lesions and plan surgeries, which can lead to fewer biopsies and post-lumpectomy re-excisions, and more breast conservation.Three Years of Use Yields Positive ResultsWe have had our system at the Cancer Center of Santa Barbara for three years. The equipment is rather simple to use and the images are quite exquisite. In our experience, we have often changed the course of treatment for patients as we have detected satellite lesions that were not seen with any other imaging modality. There has been a slow acceptance of this technology in our area, but with more studies proving its value, we are seeing an increase in the ordering of this exam.We have found patients tolerate PET mammography very well. We take four images that are eight minutes each (two of each breast). Due to the lengthy acquisitions, the patient is seated in a chair for imaging. This makes positioning more challenging for the technologist due to belly fat which is pushed upward against the bottom of the breast when seated. In traditional mammography the patient stands, which allows the belly fat to fall toward the pelvis and makes it easier to position the inferior paddle. There is a significant learning curve for the technologist for proper positioning of the breast. Additionally, lesions against the chest wall are difficult to image due to the dead space of the detectors.Naviscan now has a biopsy device that attaches to the PEM unit, allowing image-guided core biopsies to be performed. This will aid physicians in obtaining tissue within the lesion that is “active,” providing more accurate biopsy results in lesions that are unclear on mammography, ultrasound or MRI. This biopsy can be performed in 15 to 20 minutes.Various Agents Available for PEMThe PEM unit was specifically designed for high-resolution breast imaging with fluorodeoxyglucose (F-18-FDG). It is a molecule that is treated just as glucose in the body. The patient is injected intravenously with F-18-FDG, which goes to all the cells in the body. Tumor cells use more glucose than normal cells in the body. This phenomenon allows us to “see” tumor cells in the body with the appropriate equipment.New drugs are being developed with the goal of imaging the biology of the cancer in each individual in the hope of targeting specific treatment for each person. This will enhance our knowledge of the tumors seen with this imaging modality, like the estrogen-receptor F-18 product (16a-[F-18]-?uoroestradiol-17b [FES]). This may provide an in vivo method of assessing estrogen receptors in primary and metastatic breast cancers and guide management with antiestrogen chemotherapy.F-18 FLT ([F-18]-?uoro-L-thymidine [FLT]) is another drug showing promise. F-18 FLT is retained only in proliferating tissues. Every time a cell divides, it synthesizes its DNA to create a new cell. Thymidine is what is used to create the new DNA. By being able to image thymidine, we are able to see if the cells are growing or if growth is being slowed down due to therapy. [F-18]-?uoromisonidazole is a radiotracer marker for tumor hypoxia. With the advent of these drugs, it is a very exciting time for molecular imaging.The future outlook of PEM imaging is fantastic. More facilities are acquiring this technology, which will move it into the mainstream of patient care.Tricia Peters, CNMT, PET, is chief nuclear medicine technologist at the Cancer Center of Santa Barbara, Santa Barbara, Calif. She is a member of the Society of Nuclear Medicine and Molecular Imaging (SNMMI, formerly Society of Nuclear Medicine), Technologist Section. FacebookTwitterLinkedInPrint分享 News | Mammography | August 14, 2019 Imago Systems Announces Collaboration With Mayo Clinic for Breast Imaging Image visualization company Imago Systems announced it has signed a know-how license with Mayo Clinic. The multi-year… read more News | Breast Imaging | August 02, 2019 Volpara to Distribute Screenpoint Medical’s Transpara AI Solution Volpara Solutions and ScreenPoint Medical BV signed an agreement under which Volpara will sell ScreenPoint’s Transpara… read more Videos | Cardiac Imaging | July 30, 2019 VIDEO: The History of CT Calcium Scoring Arthur Agatston, M.D., clinical pro read more News | PACS | August 09, 2019 Lake Medical Imaging Selects Infinitt for Multi-site RIS/PACS Infinitt North America will be implementing Infinitt RIS (radiology information system)/PACS (picture archiving and… read more Feature | September 05, 2012 | Tricia Peters, CNMT, PET PEM: Current State and Future Outlook Positron emission mammography (PEM) is emerging as a useful modality for identifying lesions, particularly in dense breastslast_img read more