PET\CT

1. Patient Preparation

1.1 Pre-Scan Requirements
► Fasting: 4-6 hours (water permitted) to stabilize blood glucose levels
► Hydration: 500mL water intake 1 hour pre-scan to enhance radiotracer clearance
► Contraindications Check: Pregnancy, uncontrolled diabetes (blood glucose >200mg/dL), severe claustrophobia

1.2 Radiopharmaceutical Administration
► FDG Dose: 0.1-0.15 mCi/kg (3.7-5.5 MBq/kg) via IV catheter
► Uptake Period: 60±5 minutes in quiet, warm environment (reduce brown fat uptake)
► Bladder Voiding: Mandatory pre-scan to minimize pelvic artifact

2. Equipment Setup

2.1 System Preparation
► Daily QC: Ge-68 phantom calibration & CT dose verification
► Patient Positioning:

• Arms raised for whole-body scans (reduces beam hardening)

• Head first supine for brain studies (use head holder)

2.2 Protocol Selection

3. Scanning Process

3.1 CT Acquisition
► Scout View: Topogram (AP/LAT) for scan range planning
► Low-Dose CT: For attenuation correction (30-50mAs)
► Diagnostic CT: Optional contrast-enhanced (portal venous phase)

3.2 PET Acquisition
► 3D Mode: Standard for most clinical applications
► Time-of-Flight (TOF): Enabled for BMI>30 patients
► Respiratory Gating: For lung/liver lesions (optional bellows)

4. Post-Processing & Analysis

4.1 Image Reconstruction
► Iterative Algorithm: OSEM (2 iterations, 20 subsets) + PSF correction
► Matrix Size: 200×200 for body, 256×256 for brain

4.2 Quantification
► SUV Calculation: Lean body mass normalization (SUVlbm)
► Lesion Analysis: Max/mean SUV, metabolic tumor volume (MTV)

5. Radiation Safety Protocol

► Staff Dosimetry: Wear TLD badges, maintain >2m distance during FDG injection
► Patient Clearance: Confirm SUV <2.0 in bladder before discharge
► Contamination Check: Wipe test for injection area

6. Brand-Specific Notes

• Siemens Biograph: Enable UltraHD-PET for <2mm resolution

• GE Discovery: Use Q.Clear for Bayesian penalized reconstruction

• Philips Vereos: Digital photon counting requires daily detector calibration

Scan Time Optimization:
▸ Whole-body (skull-to-thigh): 15-20 minutes total
▸ Brain/Cardiac: 25-30 minutes