Protocol of Imaging for 18FDG-PET
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Positron Emission Tomography (PET) using 18 F-Flurodeoxyglucose (FDG) has been used for staging and restaging of several cancers. It has been recommended as the first line imaging modality in staging, restaging and response assessment of different cancers. Procedural guidelines from best practices guides for an oncological PET scan acquisition, confer on, imaging the body from the base of the skull to the mid thighs (from the “eyes to the thighs”), unless otherwise indicated for tumors that show a high probability of metastases in the head, skull, brain and lower extremities. The acquisition protocols at our center dictate image acquisitions to include the skull, and we have presented here cases showing the advantage of such a protocol where lesions were identified in the brain in patients who either had no symptoms or vague symptoms for the same and hence there was no indication of any disease thereof. The authors argue the case for including the skull in the PET-CT imaging which can be done with no significant constraints on total acquisition time, activity injected or radiation burden to patient or staff. The advantage offered towards tumor staging, response to treatment, and management decisions advocate the notion.