PET diagnostics

MISSION
The mission is to diagnose tumours, assess response to treatment, diagnose relapses following treatment, and obtain useful parameters for prognosis and the assessment of biological aggressiveness.

ORGANISATION
It is a simple unit attached to the Nuclear Medicine Department.
The unit carries out its specific activities in accordance with internal quality protocols, which are reviewed and updated periodically.

CLINICAL ACTIVITIES
PET (positron emission tomography) diagnostics is one of the most advanced fields of medical imaging and relies on technologically complex equipment (PET/CT) and highly qualified professionals.
PET is a tomographic examination that provides a three-dimensional visualisation of the distribution within the body of positron-emitting radiopharmaceuticals that exhibit tumour tropism.
The most commonly used radiopharmaceutical today is a glucose analogue, 18F-fluorodeoxyglucose (FDG), which is indicated for the investigation of most malignant tumours. The facility also utilises other positron-emitting radiopharmaceuticals such as 68Ga-DOTATOC (for the investigation of neuroendocrine tumours), 68Ga-PSMA-11 (for the investigation of prostate tumours) and 18F-FET (for the investigation of brain tumours; to be introduced shortly). Patients eligible for PET undergo a preliminary medical history and clinical assessment to rule out any contraindications and verify the appropriateness of the examination.
A whole-body PET scan enables the diagnosis of tumours, the assessment of response to treatment, the detection of relapses following treatment, and the provision of useful parameters for prognosis and the assessment of biological aggressiveness. The scan involves the injection of very low doses of radiopharmaceutical and is suitable for patients with almost all types of cancer. Technological assessment studies on the accuracy of FDG-PET in relation to various oncological applications have reviewed the most significant works in the oncology literature concerning the diagnosis of various neoplasms (lung, colorectal, melanoma, lymphomas, head and neck tumours, breast tumours, brain tumours, ovarian tumours, tumours of the cervix and uterine body, bladder tumours, tumours of the gastro-oesophageal tract, liver tumours, tumours of muscle and connective tissue, pancreatic tumours, prostate tumours, kidney tumours, testicular tumours and thyroid tumours). Sensitivity, specificity and accuracy values have been estimated, which overall correspond to 90%.
It should be emphasised that PET scans sometimes resolve diagnostic issues that remain unclear following other radiological imaging approaches.

RESEARCH ACTIVITIES
Several research studies have been approved at the centre, some of which are still ongoing:
▪ Diagnostic imaging of PSMA-PET in prostate cancer: the INT experience (INT-PSMA)
▪ The role of FDG-PET in assessing response to immunotherapy in solid tumours;
▪ Evaluation of quantitative FDG PET/CT parameters in patients undergoing infusion of lymphocytes transduced with chimeric receptors against B-cell antigens.

EDUCATIONAL ORGANISATION
The facility provides teaching to students on the Postgraduate Specialisation Course in Nuclear Medicine and Radiology.

FUNCTIONAL RELATIONSHIPS
Internal
- Strategic Management
- Scientific Management
- Staff units reporting to Strategic Management and Scientific Management
- Organisational units within the Foundation’s administrative and functional departments.
External
- National and international universities
- Regional and national IRCCS centres
- Centres of excellence
- Lombardy Region (in particular the Directorate-General for Welfare and the Budget Directorate)
- ATS and ASST bodies of the Province and the Region.