Interventional positron emission tomography/computed tomography: state-of-the-art

Interventional positron emission tomography/computed tomography (PET/CT) is becoming a "hot" topic at major interventional radiology meetings, particularly as it pertains to interventional oncology. The ability to target malignancies and other disease processes for diagnostic or therapeutic procedures using metabolic characteristics, rather than anatomic features only, is proving invaluable. Fluorine-18 fluorodeoxyglucose (FDG) is a major PET radiopharmaceutical in use today, in part because of its lack of specificity. Many malignancies demonstrate FDG avidity, making FDG a widely applicable tracer. FDG can be used to distinguish regions of viable tumor from necrotic tissue and can even suggest regions of more aggressive tumor biology in some cases. Much of the excitement over interventional PET/CT, however, centers on the seemingly limitless possibilities of using novel PET tracers, existing and yet to be imagined, for the targeting of biological markers or disease processes in our patients. This review of interventional PET/CT focuses on practical considerations regarding equipment, patient preparation, radiation safety, image acquisition, intraprocedural image interpretation, and other topics important to successful performance of PET/CT-guided interventional radiology procedures.