MVZ Friedrichshain

PET-CT Zentrum

Adresse
Haus 15.2 EG
Landsberger Allee 49
10249 Berlin
(030) 130 23 1009

Anfahrt

Examination spectrum (Please click!)

  • PET CT with F18 - FDG

    Oncological applications

    The 18F fluorodeoxyglucose (FDG) is being absorbed by the cells like natural glucose (grape sugar) and shows places with increased metabolic activities within the body. Most of the malign tumors (but not all of them) have a very active metabolism and absorb higher amounts of glucose. Also smaller tumors resp. metastases can therefore be detected very early.

    61 year-old patient after the surgery and chemotherapy of an ovarian carcinoma. The conventional imaging (ultrasound, CT, MRI) could not detect a relapse despite the increase of the tumor marker CA-125. FDG PET-CT shows metastases at smaller retroperitoneal lymph nodes (diameter < 1 cm). Another surgery with the removal of lymph node metastases was performed against the background of the PET-CT findings.

    Cerebral examinations  

    The advantages of PET-CT are very clear also in respect of the cerebral imaging. A very early diagnosis can be determined e.g. in the context of diseases which include a decrease of the cerebral metabolism, like in case of an Alzheimer`s dementia. We additionally perform cerebral PET examinations with epilepsy-patients in order to localize the place of origin of the seizures in the course of the surgery preparation. In order to reach a better allocation of the PET-findings, we combine the PET-data by means of image fusion techniques with CT- or MRI-pictures at our department and analyze them layer by layer. We furthermore use a special computer-system (BRASS), produced by the company HERMES, which compares individual images with the summation images of healthy persons and which significantly facilitates the analysis of findings.

    8% of individuals at the age of >65 years and 30% of individuals at the age of >85 years suffer from an Alzheimer's dementia. Against the background of the demographic development, a triplication of the dementia cases has been forecast for the total population of the industrial countries within the period of the next 50 years. Different compounds for the treatment of dementias have been proposed during the last years; the effectiveness of some of them is being considered as proven in the meantime. An early therapy of dementia-diseases always depends on an exact diagnosis. FDG-PET allows the detection of a dementia-disease already at a very early stage and furthermore facilitates a differentiation between Alzheimer`s dementia and other dementia-diseases.

    62 year-old employed patient with slight memory-disturbances. The FDG-PET shows a reduced metabolism within a typical area of the brain and thus proves a beginning Alzheimer’s dementia.

    Preparation of the patient 

    It is very important that the patient undergoes the examination in a fasting condition (supper on the day before the examination is allowed but the patient must not have breakfast on the day of examination). It is allowed to drink water. You are also allowed to take your normal medication.

    The course of examination

    A small amount of the weakly radioactive substance (18F-FDG) will be i.v. injected. A resting phase of up to 90 minutes enables the substance to spread within the body in order to be absorbed by the cells. For the subsequent measuring, you will – on a patient couch - slowly be moved through the measuring ring of the tomograph. This will take approx. 20 min. in case of a total body measurement. The PET-examination will be combined with a computer tomography (CT) in order increase the information value of the PET-imaging. At this, it might be required to administer additional contrast medium orally and/or i.v.

  • PET CT with F18 - FET (Tyrosine)

    The amino acid tyrosine is a natural basic element of the protein metabolism. Tyrosine, marked with the radioactive isotope 18F, (18F-FET) shows a very high specificity for the representation of cerebral tumors and is being used in order to define them against healthy cerebral tissue (e.g. in the context of a radiation therapy-planning) and for the early diagnosis of relapses in particular.

    This patient had suffered from a relapse of a malign cerebral tumor. A tyrosine-PET examination was performed in the context of preparations for a 3D stereotactic radiation therapy (right picture). At this, the tumor borders could be specified so that one could exclude healthy cerebral tissue from the toxic radiation.

    The MRI examination of this 30 year-old patient led to the suspicion of a cerebral tumor which did however not enhance the contrast so that one acted on the assumption of a low degree of malignity. The PET with 18F-FET showed a metabolically active region in the lower part of the tumor (see 3rd picture right side) however without increased amino acid metabolism of the remaining regions. The histological examination of the specimen, which had been taken PET-guided (left picture), showed an astrocytoma III°, i.e. a malign tumor.

    As regards the determination of the place of puncture, the contrast medium – supported MRI is being used in particular. Cerebral tumors which do not show a contrast enhancement at the MRI are however problematic. As regards these cases, a cerebral PET-examination with radioactively marked amino acids is being used. In order to be able to perform imaging-guided interventions successfully, MRI- and PET-images should be taken without major time differences resp. should then be transferred to the neurosurgical surgery systems. This requires a close cooperation between the radiologists, nuclear medicine specialists and the neurosurgeons.

    Preparation of the patient 

    In order to avoid a saturation of the amino acid metabolism, you should begin a minimal protein diet 12 hours prior to the examination (No fish, no meat, no eggs, no milk products etc. Better: Bread, noodles, jam, coffee). 

    The course of examination

    A dose-reduced cerebral CT (without contrast medium) will be performed 10 minutes after the injection of the weakly radioactive substance (18F-FET). The subsequent cerebral PET measurement takes 15 minutes.

  • PET CT with F18 - choline

    A combination of 18F and choline is helpful as regards the diagnosis of prostate cancer. The choline is an element of the cell-membranes and is strongly being absorbed by prostate carcinomas and their metastases. PET-CT with 18F-choline is used for the primary staging in the context of the bioptic proof of prostate carcinomas and particularly for the relapse diagnostics (in case of increased PSA).

    18F-choline PET detects a metabolically active prostate carcinoma, shows however no evidence of lymph node metastases or distant metastases. The patient could therefore be treated with a milder kind of radiation therapy.

    F18-Choline PET-CT shows multiple lymph node and bone metastases in recurrent prostate cancer.                             

    Preparation of the patient

    A special preparation is not required.

    The course of examination

    A total body measurement of 20 minutes which consists of a computer tomography (CT) and of a PET-examination will be performed 10 minutes after the i.v. injection of the weakly radioactive substance (18F-choline). The additional i.v. injection of contrast medium is often required.

  • PET CT with GA68 - DOTATATE

    Some tumors have specific receptors, the so-called somatostatin-receptors. This applies to many neuroendocrine tumors but also to some cerebral tumors (e.g. meningiomas).  Somatostatin is a peptide-hormone which naturally occurs within the body. Somatostatin-analogues (somatostatin-like molecules) have been used for different kinds of diagnostics and therapy for many years. The tracer Ga68-DOTATATE can mark tumors with somatostatin-receptors on their surface.

    18F-DOTATATE proves a mengioma relapse with affection of the cranial base bones. The somatostatin-receptor-positive tumor cannot be differentiated by means of MRI. PET-CT data supported the planning of the highly precise stereotactic radiation therapy.

    Ga68-DOTATATE PET-CT shows multiple somatostatin receptor - positive metastases of a neuroendocrine tumor.

    Preparation of the patient

    A special preparation is not required.

    The course of examination 

    A small amount of the weakly radioactive substance (Ga68-DOTATATE) will be i.v. injected. A resting phase of up to 90 minutes enables the substance to spread within the body in order to be absorbed by the cells. For the subsequent measuring, you will – on a patient couch - slowly be moved through the measuring ring of the tomograph. This will take approx. 20 min. in case of a total body measurement. The PET-examination will be combined with a computer tomography (CT) in order increase the information value of the PET-imaging. At this, it might be required to administer additional contrast medium orally and/or i.v.

  • PET CT with F18 - DOPA

    L-DOPA is an amino acid which participates in different metabolic activities of the body. It is a precursor of several biologically relevant substances, among other things of melanin, dopamine, adrenaline and noradrenaline. The tracer 18F-DOPA is being used for diagnostics regarding different neuroendocrine tumors (e.g. pheochromocytomas, paragangliomas) and in the context of medullar thyroid gland carcinomas.

    Preparation of the patient

    A special preparation is not required.

    The course of examination 

    A small amount of the weakly radioactive substance (18F-DOPA) will be i.v. injected. A resting phase of up to 90 minutes enables the substance to spread within the body in order to be absorbed by the cells. For the subsequent measuring, you will – on a patient couch - slowly be moved through the measuring ring of the tomograph. This will take approx. 20 min. in case of a total body measurement. The PET-examination will be combined with a computer tomography (CT) in order increase the information value of the PET-imaging. At this, it might be required to administer additional contrast medium orally and/or i.v.

    Patient with a rare genetic defect which is associated with neuroendocrine tumors. 18F-DOPA PET-CT was performed for purposes of tumor detection and showed a metabolically active paraganglioma in the region of the neck. (Glomus tumor).

  • PET CT with F18 - NaF

    PET-CT with the tracer 18F-NaF is being applied in the context of bone-metastases. The advantages of this method over the conventional skeletal scintigraphy are a higher spatial resolution and the 3D examination technique. The 18F-NaF PET-CT therefore allows the detection of smallest osseous metastases.

    The course of examination 

    A small amount of the weakly radioactive substance (18F-NaF) will be i.v. injected. A resting phase of 30 minutes enables the substance to spread within the body in order to be absorbed by the cells. For the subsequent measuring, you will – on a patient couch - slowly be moved through the measuring ring of the tomograph. This will take approx. 20 min. in case of a total body measurement. The PET-examination will be combined with a dose-reduced computer tomography (CT) in order increase the information value of the PET-imaging. At this, contrast medium will not be injected.

Research projects

"A prospective, multicenter trial on the value of 18F-FET PET in the post-therapeutic evaluation of childhood brain tumors.’"

Short title: FET PET 2010
EudraCT-No.: 2008-005786-60

Head of studies / Pediatric Oncology

PD Dr. H. Hernáiz Driever
Pediatric Department with the focuses Oncology and Hematology
Charité – University Medicine Berlin

Head of studies / Nuclear Medicine

PD Dr. M. Plotkin
Institute for Nuclear Medicine Vivantes Mitte/Nord, Berlin
Coordinator of studies
Dr. med. A. Guggemos

Coordinator of studies

Dr. med. A. Guggemos
Pediatric Oncology and Hematology
Pediatric Hospital Amsterdamer Str., Cologne

Supported by

Deutsche Kinderkrebsstiftung (DKKS) / German Child Cancer Foundation