Molecular Imaging Insight - May 2008 - (Page 8) by rODNey J. hiCK s, mD, fr aCP CAN WE AFFORD In 1995, a massive earthquake hit Kobe, Japan. With inadequate foundations, many buildings simply toppled over. Subsequently, NOT to Use FDG-PET? tional structural imaging performs relatively poorly in all these roles. With such a poor footing, is it surprising that the superstructure of building codes were revised to ensure that buildings were constructed oncological therapy so often collapses? If there with foundations capable of withstanding similar seismic events. Ten were a technique that manifestly improved the ability of oncologists to make informed deciyears later, a scandal broke when it was found that an architect had sions regarding patient management, wouldn’t been flouting these codes and authorizing as compliant buildings that it be scandalous not to embrace it in order to prevent unnecessary loss of life and inapproprihe knew to have been constructed to inferior engineering standards. ate expenditure of scarce healthcare resources? Although no building had collapsed, the public were justifiably Yet this is what has happened over the past 10 to outraged at the potential risk to life. 15 years in the case of PET. Numerous studies validated by pathological findings, serial imaging follow-up, and most importantly in the case he foundation on which modern oncology is built of cancer the ability to stratify survival, have compellingly demonis the accurate detection of cancer, determination strated that FDG-PET generally outperforms not only individual of the extent of disease, and post-treatment diagnostic tests, but also a combination of tests in many cancers. assessments of the success of treatment. This proIn particular, the great strength of FDG-PET is its capability to cess of diagnosis, staging, and therapeutic detect remote systemic and regional nodal metastases. In diseases response assessment intimately involves imaging. where the management options extend from surgery for local Unfortunately, in very many cancers, we know that conven- T 8 Molecular Imaging Insight | May 2008 MolecularImaging.net http://MolecularImaging.net
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