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What is a PET CT Scan?

A positron emission tomography (PET) scan is an imaging method using positron emitting radionuclides labelled with different pharmaceuticals and studies their bio-distribution (Emission scan).This when combined with CT scan (transmission) scan is called as PET-CT scan

The tracer may be injected, swallowed or inhaled, depending on which organ or tissue is being studied by the PET scan. The tracer accumulates in areas of your body that have higher levels of chemical activity, which often correspond to areas of disease. On a PET scan, these areas show up as bright spots.

A PET scan is useful in detecting and staging/Grading various ailments like cancer, coronary artery disease, tuberculosis and other inflammations 

Why it’s done & it’s Risks; How to  prepare; What you can expect; Results

PET –CT scan is an effective procedure, which assists in detecting chemical activity levels in the body.  It is helpful in ruling out various disorders in brain and heart, including cancers. It is more effective than CT and conventional MRI has molecular changes appear earlier than morphological changes.  There can be multiple conditions where PET- CT scan is very useful. Some of the disease conditions are as mentioned.

Brain Disorder
  • Alzheimer’s Disease
  • Brain Tumors
  • Parkinson’s disease
  • Stroke
  • Seizures (Epilepsy)
Cancer Cell

Cancerous lesions are often seen as bright spots in a PET-CT scan as the cancer cells have high levels of metabolic rate as compared to the normal cells. Thus the PET scans are helpful in the following scenarios:

  • Characterizing  tumors
  • Staging of the cancer(whether it is localized or it has spread throughout the body)
  • Suspected   progression of disease  (whether treatment is effective or non- effective)
  • Recurrence of cancer

It is very important to read the findings on a PET scan very carefully as some benign lesions show abnormal metabolic activity. There can be multiple types of cancers, which can be detected and diagnosed by PET scans. Some of these are highlighted below.

  • Breast cancer
  • Brain cancer
  • Lung cancer
  • Esophageal cancer
  • Cervical cancer
  • Colorectal cancer
  • Lymphoma
  • Melanoma
  • Head
  • Neck
  • Thyroid
  • Prostate
  • Pancreatic
Heart Disorder

Multiple different types of heart related disorders can be diagnosed with PET scans. Some of these disorders include.

  • Examine decreased blood flow in the arterial territories
  • Myocardial inflammation.

TYPES OF PET-CT SCAN

Fluorodeoxyglucose PET or FDG PET

Since tumours need sugars to grow, fluorodeoxyglucose is used. It is a sugar-like substance with the ability to bind with sugars. When it is introduced into the body, it gravitates towards with highconcentrations of sugar. While it can be used to find tumours in any part of the body, it is specifically useful to image inflammation, infection, and brain function.

DOTA-NOC PET

This drug is typically used to detect neural or neuroendocrine tumours.

Fluoride Bone PET

As the name suggests, it is useful to create images of bones.

Fluorothymidine PET or FLT-PET

FLT helps to detect fast-replicating cells and is typically used for imaging bone marrow, brain tumours, and other clinical trials.

Fluorocholine PET or FCH-PET

This drug is used to image prostate cancer

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How is a PET scan performed?

  • Talking about the procedure of a PET CT Scan, at the beginning of the procedure, a tiny amount of radioactive material (which helps in projecting accurate images) is injected into the body. It is not a painful process or the patient does not feel any different.
  • Generally, the radioactive substance will automatically dissolve and absorbed by the body within an hour. The patient is required to wait until then.
  • Around an hour later, the patient is taken to a PET CT scan machine room and asked to lie on a table there. After lying in position, the horizontal table moves upwards into the machine and the patient will move into the imaging machine. This machine has a wider and larger opening than an MRI. 
  • Usually, it takes around one hour to complete the PET CT scan.

How  Should You Prepare for PET CT Scan?

  •  Patient should be on fasting (6-12 hours) prior to scan.
  • Appointment will be given prior to the day of scan.
  • If patient is diabetic, and is on medication like METFORMIN, please notify the doctor as Metformin should be stopped two days before .
  • If patient is diabetic and using insulin, then should withhold insulin on the day of scan and fasting blood glucose should be less than 150mg/dl.
  • Kidney function test should be done.(within 1 weak  of scan is acceptable)
  • Patient should be cooperative. If not inform doctor especially if needing sedation.
  • If patient had underwent chemotherapy or radiotherapy, notify doctor.
  •  Scan is not done for pregnant women unless there is no other test available

Know More About PET CT Scan

During the procedure:

  • The PET-CT scan machine is similar to a CT-Scan machine. In terms of shape, the machine is big hollow circular shaped.
  • The procedure takes around 3-4 hours to complete and no hospitalization or admission is required and the procedure can be performed in an out-patient facility in the Nuclear Medicine Department.
  • During the procedure, a radioactive drug known as tracer is given to the patient. It can either be inhaled, swallowed or injected, depending upon the tissue or organ to be examined.
  • The patient is then asked to wait for about 60 minutes(based on tracer)for the tracer to get absorbed in the body.
  • Further, the patient is asked to lie down on a thin padded examination table, which slides into the scanner.
  • The patient is asked to stay still during the scan, as the images from the scan can get blurred, if the patient moves during the scan. This step takes approximately 30 minutes to complete.
  • The PET scan is a painless procedure. However, the patient might feel a little anxiety while in the scanner especially if the patient is claustrophobic. However, if the discomfort level increases, the patient must inform the technician or nurse. In such cases, a drug can be given to calm the patient.
  • The images captured during the scan are sent to the lab for further interpretation.

After the procedure:

After the procedure, the patient is asked to change into normal clothes and is advised to drink plenty of water/fluids in order to flush out or remove the tracer from the body. The patient can go home after the PET-CT scan is performed and resume normal routine activities. The patient can drink and eat normally after the PET –CT scan procedure is complete.

The nuclear physician interprets the images from the scan and prepares the report, which will further be handed over to the concerned doctor. The doctor examines the report carefully and discusses the results with the patient in detail. If the report is normal, it means the patient is fit and healthy with no abnormality detected. If the report is abnormal, it means that there are some abnormalities, which would need the attention of the doctor. The cancerous cells appear as bright spots in the image. The bright spots indicate cancer cells with high metabolic activity.

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Why is a full-body PET CT scan prescribed?

In order to diagnose and monitor cancer and its ongoing treatment, a PET CT Scan is prescribed. As many people are getting affected with cancer in India, PET CT Scans are required by medical doctors as they are a major key for cancer treatment.

Reasons for using PET Scan:

  • Diagnose cancer
  • Make decisions about cancer therapy
  • Determine the effectiveness of the ongoing cancer treatment
  • Brain disorders
  • Disorders of heart
  • Disorders of the central nervous system.

Prerequisites for PET CT Scan

The following are the prerequisites for a PET CT scan if the contrast dye is used in the procedure.

  • Min. 8 hours of fasting. In the case of diabetics, stop the diabetic medications and ensure fasting blood sugar level should be 180mg/dl without taking medication on the day of the test.
  • If you have any previous medical records like the old PET-CT report, it is advisable to carry them along to the lab.
  • Report the lab 30 minutes prior to the scheduled time and you may be required to remain for at least 4 hours in the lab from the scheduled time.