PHYSICS SHE TASK

PET SCANS

SACE NUMBER: 132172G

Introduction:

The probability of a certain material being imaged for medicinal purposes was first recognised in the
early 1950s. Positron emission tomography, or PET, is an abbreviation. The use of PET as a diagnostic
tool and for research of the dynamic human metabolism by the middle of the 1980s demonstrated
the significant advancements in PET technology over the previous ten years. This thesis explores the
operation of PET scans and their present use in the field of oncology through the use of physics
concepts. The application and limitation SHE fundamental concept will be the key focus of this
report. Recent clinical trial findings have demonstrated how properly using PET scans can make a
major difference in the management of patient care in addition to demonstrating how PET scanning
is superior to traditional imaging in the diagnosis and management of several forms of cancer
(Stanford Health Care, 2020).

Physics of PET Scans:

PET scans are used by medical professionals to look for disorders in people (Healthline, 2018). This
enables early diagnosis of diseases like malignancies, neurological disorders, and cardiovascular
conditions by medical professionals (Betterhealth, 2019). Using radioactive materials known as
radiotracers, a PET scan is an imaging analysis that shows how the tissues and organs of an organism
function within the human body. The antimatter counterparts of electrons, positron-emitting
radiotracers, are used in a gamma imaging technique to evaluate this (Johns Hopkins Medicine, n.d).
Depending on the target process within the body, different tracers are utilised for various imaging
tasks. For instance, NaF-F18 is frequently used to identify bone development, 18F-FDG is typically
used to diagnose cancer, and oxygen-15 is frequently used to assess blood flow (Healthcare Imaging
Services, 2017). Additionally, radiopharmaceutical (a chemical that emits positrons) is injected into a
patient during a PET scan without any discomfort (Betterhealth, 2019). This procedure is often
finished by injecting radioactive atoms into the contaminated area, such as Fluorine-18, Carbon-11,
or Nitrogen-13 (FREUDENRICH, n.d). By subjecting regular compounds to neutron bombardment,
such radioactive atoms are produced, leading to transient radioactive isotopes. When these
radioactive atoms are injected into the body, they emit concurrent annihilation pairs of gamma rays
at an angle of 180°, making it possible to pinpoint their source along a line. A specific location of any
radioisotope concentration is provided through data collecting for multi-angle emissions
(Hyperphysics, 2018). A tomograph, often known as an image of a slice of the body, can be created
by utilising the detector ring shown in
figure 1. When these radioactive atoms
are injected into the body, they emit
concurrent annihilation pairs of gamma
rays at an angle of 180°, making it
possible to pinpoint their source along
a line. A specific location of any
radioisotope concentration is provided
through data collecting for multi-angle
emissions (Hyperphysics, 2018). A
tomograph, often known as an image
of a segment of the body, can be
created by utilising the detector ring
shown in figure 1.

Figure 1 – ring of detection used for PET scans

An electron immediately follows the emission of positrons from a nucleus, and the pair instantly
annihilates, splitting the mass energy of the two particles into two gamma rays (Hyperphysics, 2018).
The two gamma-ray photons are moving in opposite directions because of the need for momentum
conservation due to their shared momentum. Gamma-ray photons that are simultaneously detected
by two detectors put the source along a line that connects them.

The most popular tracer used in PET scanning is FDG, also known as 2-[18F] fluoro-2-deoxy-D-
glucose (Virtual Medical Centre, 2017). The body component that requires a lot of sugar, FDG,
travels there and breaks down since it is similar to glucose. It releases a positron upon its
decomposition. This interacts with a patient electron to produce radioactive waves (HyperPhysics,
2018). As a result, the PET scanner can detect these waves by turning them into electrical signals
that can then be processed by a computer.

Different intensities of light in a PET scan represent various stages of tissue or organ activity. The
computer can produce representations of the role of the target tissue in various colour codes
(VirtualMedical Centre, 2017). Healthy tissue builds up some of the tagged glucose that would
appear on the PET pictures as it uses glucose for energy. However, because of the uncontrolled cell
proliferation, malignant tissue uses more glucose than healthy tissue. As a result, a lot of the
material has collected, making the tissue on the PET pictures appear brighter than usual. As a result,
PET scans are the most frequently used to detect cancer since they may detect biochemical changes
in the affected body, the extent of the disease's spread, and the availability of appropriate
treatments (NPSMEDICINEWISE, 2008, BetterHealth, 2019)

Applications and Limitations:

In the realm of cancer nowadays, PET is a functional imaging technique that is well-established and
widely employed (MAYO CLINIC, 2020). Since 18F-FDG is a glucose analogue, it is utilised for
metabolism by cells that use glucose. Hexokinases phosphorylate glucose. Rising levels of this
enzyme's mitochondrial form are found in malignancies that are progressing quickly. The radioactive
glucose molecule is metabolically trapped, enabling the use of the PET scan (ASM,2011). The use of
18F-FDG allows researchers to investigate the possibility of cancer metastasizing to different body
regions. The concentrations of imaging FDG tracer show tissuemetabolic activity as they correspond
to the regional glucose uptake. The majority of current scans, or almost 90% of them, are this type of
18F-FDG PET scan for detecting cancer me tastases (Kapoor, Kasi,2020)

After its initial invention, the PET scan has been around for a while and has developed into a well-
known nuclear imaging method that has proven particularly helpful in oncology. Midway through
the 1970s, the Mallinckrodt Institute of Radiology at Washington University created PET, which was
quickly embraced as a significant research tool in the fields of neurology and cardiology. But it took
researchers longer than two decades to recognise that PET could also be a useful tool for oncology
(Griffeth, 2005). PET is a very pricey modality that requires both expensive equipment and a PET
scanner that costs at least $1 million. To produce the radiopharmaceuticals needed for PET imaging,
only personnel with extensive training are permitted to utilise this equipment. However, thousands
of these scanners are currently in use around the globe, benefiting human health and having a
significant impact on global civilisation (Griffeth, 2005, Cancer.Net, 2020).

Due to the relatively recent development and utilisation of PET scans in oncology, the typical cost of
a PET scan is very high, averaging between $900 and $1400. (MMI, 2019). Thoracic cancer, brain
carcinoma, and stomach cancer patients are the ones who receive FDG-PET scans in Australia in the
greatest numbers. In 2015, these figures added up to a total eligible population of 13,200. (ANZHSN,
2019). This is a body of evidence demonstrating how the desperate patient can significantly profit
from this cutting-edge scientific PET scanning technology. With new facilities and signals indicating
further growth every year, PET scanning is currently very popular and expanding quickly.

The limitations surrounding PET scans may limit the conclusions that may be drawn, even if the use
of PET scans in cancer can significantly help the patients and may outweigh the drawbacks. The
employment of short-lived radionuclides is constrained by the need to reduce the radiation dose to
the subject (NCBI, n.d). In addition to its well-established role as a diagnostic tool, PET is increasingly
used to assess the effectiveness of therapy, particularly cancer therapy, where the risk to the patient
from ignorance of the course of the disease is considerably higher than the risk from test radiation
(dip, 2019). The elderly and pregnant cannot use the tracers due to radiation risks because they are
radioactive isotopes (MAYO CLINIC, 2020). The high expense of cyclotrons necessary for processing
short-lived radionuclides for PET scanning and the requirement for specifically developed chemical
synthesis facilities on site to create radiopharmaceuticals following radioisotope preparation limit
the use of PET in oncology (PROMETEON, 2020). Many of the tracers are absorbed by inflammatory
conditions, which is important because PET scans may indicate high-activity regions that could be
mistaken for malignancies. These ailments, which could include rheumatoid arthritis or TB, could
lead to perplexing outcomes. If not done properly, this could lead to a wrong diagnosis and pose
serious hazards for the patients (Virtual Medical Centre, 2017).

Patients assert that the radioactive isotope used in PET scans may lead to further difficulties and
pose health hazards to the patients because science is a subject of public debate. However, these
radio isotope tracers can have a negative impact on human health and pose serious hazards.
Additionally, slow-growing, less aggressive tumours may not absorb much tracer, and small tumours
(less than 7 mm) may not be detectable, making PET scans less reliable in some circumstances. The
cells may absorb this regular sugar rather than the radioactive one that was injected when blood
sugar levels are high. To reduce the likelihood of this occuring, patients are often fasted for 4 hours
prior to a PET scan, and blood sugar levels are checked (HealthEngine, 2005).

Conclusion:

Using radioisotopes, PET enables diagnostic imaging of metabolic activity. When it comes to treating
cancer, research on the uses and restrictions of PET scans, specifically in the field of oncology,
suggests that utilising PET scans is far more beneficial than using any other radioactive imaging, such
X-rays. The use of PET scans shows a higher benefit rate for both the economy and specific patients.
Since there is possibility for using PET scans in additional ways that will benefit society. Although PET
scans are expensive now since they are a relatively new technology, if this breakthrough is
successful, more research on PET scans may be conducted to investigate additional applications that
could improve their performance and make them more affordable. Despite this, there is still a lot of
opportunity for PET scans to advance; the public has yet to witness any of the breakthroughs that
PET scans are capable of.
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