The non-urological indications are not discussed here. Currently, though there are no absolute urological indications, PET may contribute in the following pathological processes:
• Testicular tumors
■ Primary tumor staging
■ Early detection of recurrent disease
■ Assessment of residual tumor burden after therapy
• Renal cell cancer
■ Initial staging of local and distant disease
■ Detection of recurrence
• Bladder cancer
■ Detection of recurrent disease (if other imaging ambivalent)
• Detection of bony metastases (if bone scan equivocal) Technique and radiation
The are no specific contraindications to PET scanning except for women who are pregnant and breastfeeding.
• Patients advised to avoid food for 4-6 hours and oral intake restricted to non-sugary clear fluid
• Blood glucose estimation is performed just prior to the examination to ensure low glucose levels (high levels inhibit FDG uptake by cells)
• In addition, buscopan (20 mg) and/or diazepam may be administered to reduce FDG uptake by the intestines and muscles, respectively
• A preliminary background scan is performed before up to 400 MBq of FDG is injected intravenously
• Imaging is performed between 45 and 90 minutes after tracer injection
• A whole body scan can be performed or imaging restricted to the area of interest, with or without simultaneous CT scanning
A maximal injected dose of 400 MBq corresponds to an effective radiation dose of 10 mSv (equivalent to up to 6 years of background radiation).
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