CME 6 Session - EANM'14

Interactive: PET and Bone Metastase

Educational objectives:
Interactive presentation of real cases of patients, to illustrate the role of PET, fused with CT or with MRI:
  • criteria for the detection of bone metastases on PET/CT at staging and restaging
  • how to select the PET tracer(s) according to the primary cancer: fluoride, metabolic cancer tracer, or molecular specific approach
  • how to schedule treatment monitoring with PET according to the treatment regimen (anti-hormone, cytotoxic, non-cytotoxic inhibitors) and its timetable?
  • influence of the type of primary cancer and of the phenotype of the bone metastases determined on CT (clastic, blastic, mixed, diffuse) on the choice of the PET tracer for treatment follow-up
  • what are the quantitative criteria, which have been validated?
  • how to avoid or deal with flare on PET (and on CT)?
  • how to deal with interfering therapies (CSF and others …)?
  • what are the minimal MRI sequences that must be available for search of follow-up of bone metastases? Is contrast-enhancement necessary?
  • is the choice of MRI sequences depending on the age of the patient, on the cancer type?
  • what are the diagnostic performance of whole-body MRI and MRI with diffusion-weighted imaging to detect bone metastases?
  • is it possible to evaluate therapy response of bone metastases with MRI? What are the relevant quantitative parameters?
  • how a PET/MRI examination should be performed in practice to detect or confirm bone metastases? to monitor treatment? to restage recurrent cancer?
The audience will be equipped with voting systems. The aims are:
  1. to favour a better prescription of PET/CT among the diagnostic tools in those settings. The performance of PET/CT depends on the PET tracer
  2. to check the choice of PET tracer and CT or MRI image acquisition parameters
  3. to improve interpretation of PET/CT imaging by the attendees (avoiding pitfalls)
The presentations will cover the current and potential role of PET/CT and PET/MR to detect and monitor treatment of bone metastases. With the help of newer tracers and good correlative interpretation, the use of PET/CT may be optimised. The session will also try to identify at this early point how to integrate MRI to add value in the search of bone metastases, be this as separate examination or as integrated PET/MRI, even though little data exist on this new modality. Voting systems will allow the attendees to express their opinions and to evaluate their experience and skills in this field.

Key Words:
Interactive Session, Bone Metastases, Treatment Monitoring, PET/CT, MRI, PET/MRI, 18F-FDG, 18FFluoride, 18F-Fluorocholine, 18F-FluoroDOPA, 68Ga-DOTATOC
Teaser Video
A short description by Frederic Paycha, chair of the EANM Bone & Joint Committee

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