PET-CT scanning overview

Paul Strickland Scanner Centre acquired its first PET-CT scanner in 1998, after Dr Paul Strickland founded the charity in 1985 to acquire new scanning technology not available on the NHS at the time. Since then, the clinicians at the centre pride themselves as being versatile and forward thinking, providing the highest standard of PET-CT service – fully compliant with the Imaging Services Accreditation Scheme (ISAS).

The centre has several key advantages for people who need a PET-CT scan:

  • As a charity it is buffered to a much greater extent from the current financial constraints of the NHS. This means that we able to respond rapidly to advances in technology, and we have currently two cutting edge PET-CT scanners.
  • We provide a scanning service which includes weekends. This increases choice for patients, reduces the time patients have to wait before their scan, and reduce the time from initial presentation to diagnosis.
  • We have a preferential supply of radioisotopes vital for PET imaging from an onsite cyclotron, ensuring a reliable supply of radiotracer for our patients. Only very rarely do scans have to be cancelled due to a lack of radiotracer.

We are committed to serving our NHS patients and work closely with the Mount Vernon Cancer Centre (MVCC) and associated multi-disciplinary teams (MDTs). Clinicians often visit us to discuss urgent issues regarding diagnosis and treatment with our acclaimed, friendly and knowledgeable radiologists.

We have a reputation for delivering world class PET-CT research with a dedicated superintendent radiographer research lead, PhD medical physicist and internationally renowned radiologist, leading to ground-breaking clinical trial studies with management changing results. Studies have been published some of the most influential journals, such as the New England Journal of Medicine (N Engl J Med. 2016 Apr 14;374(15):1444-54). We also supervise MSc, MD and PhD students undergoing clinical imaging research studies.

About the team

We have a close-knit, experienced PET-CT team of booking secretaries, radiography assistants, radiographers, onsite physicists and radiologists devoted and dedicated to working together to provide a compassionate patient focused PET-CT service of the highest quality. All staff undergo regular continuous professional development (CPD) training to ensure they are aware of the latest developments in their areas of expertise and in compliance with regulatory requirements.

The service is headed up by our highly experienced PET-CT superintendent, Gwen Benyon. Victoria Major, our research radiographer lead, is studying for a PhD and has an academic post with the University of Hertfordshire with student supervision. Bal Sanghera, our PET physicist, is a trustee for the Institute of Physics and Engineering in Medicine and medical physics examiner for the Royal College of Radiologists. In addition, our eminent PET-CT lead radiologist Dr Wai Lup Wong is the Clinical Guardian for PET-CT at NHS England, Chair of the Cancer Diagnostics CRG NHS England and is an appointed assessor for the Imaging Services Accreditation Scheme, UK Accreditation Service (ISAS UKAS).

Our PET-CT scanners

We have two PET-CT scanners which are predominantly used for whole body imaging, using radioactive glucose, i.e. FDG, in people with cancer. Beyond FDG, PET radiotracers specific for prostate cancer are used routinely; for example we use18-F Choline to improve care of people with prostate cancer.

In addition, the centre provides a PET-CT service for appropriately investigating people who do not have cancer, including those with fever of unknown origin (PUO) and suspected vasculitis. We also provide a specialist FDG PET-CT brain imaging service for the Harrow memory clinic through Northwick Park Hospital.

Specific features

The centre’s PET-CT scanners have specific features that enable us to scan with low radiation doses, improving patient safety. Wide fields of view scanners, use of automatic dose reduction hardware and software techniques enable dose reduction while maintaining image quality.

The centre performs low-dose PET-CT, followed immediately by a contrast enhanced high dose CT on the same scanner to optimise workflow and for the ease of our patients.

We have radiotherapy-approved lasers fixed on the walls of our latest PET-CT scanner room, enabling us to integrate PET-CT into radiotherapy treatment planning at Mount Vernon Hospital. It is currently being considered for people with lymphoma in particular.

Example scan images

Dementia

Dedicated brain FDG PET CT with comparison to normal database. The distribution of glucose uptake in the brain is imaged by the PET component of the scan, this is then co-registered with the CT component which gives anatomical information about the cortical volume and any intracranial lesions. The patient's data can then be mapped onto a normal database which is a summed PET volume of 200 age-matched healthy subjects. Subtraction of the normal database from the patient's scan highlights any areas of hypometabolism (shown in blue). The pattern of hypometabolism can aid in the diagnosis of the patient's dementia subtype.

This case shows the typical Alzheimer's dementia pattern of hypometabolism in the posterior parietal and temporal lobes and the precuneus.

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Vasculitis

FDG PET CT is also indicated in the investigation of vasculitides. These cases show mural inflammatory FDG uptake in the arterial tree, diagnosing active arteritis. The extent of involved vessels is clearly demonstrated.

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Prostate Cancer

A man with prostate cancer treated with prostatectomy previously. PSA level was found to be elevated during follow-up. MR showed no active disease. F-choline PET CT shows a small bone deposit in the the LT femur.

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Enlarged abdominal lymph nodes

A woman who presented with enlarged abdominal lymph nodes during surgery for appedicitis. FDG PET-CT shows extensive disease in the upper abdomen. In addition it shows unexpected disease in lymph nodes in the chest and within the head and neck.

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