Positron Emission Tomography (PET)

Saba Parvin Haque
MSc in Neuroscience
from “Sophia College For
https://www.youtube.com/chann
Women”, Mumbai. el/UCAiarMZDNhe1A3Rnpr_WkzA
Positron Emission Tomography
Positron: a subatomic particle with the same mass as an electron and a numerically equal but
positive charge.
Saba Parvin Haque
Emission: the production and discharge of something,
MSc Part 2 especially gas or radiation.
P20013
Tomography: a technique for displaying a representation of a cross section through a human
body or other solid object using X-rays or ultrasound.
Reference: Oxford Languages and Google - English | Oxford Languages. (2022, August 12). from https://languages.oup.com/google-dictionary-en/
PET
What is
PET?
PET offers
Quantitative
Analyses:
Figure: Explanation of the term “positron emission tomography” (Waarde, 2012).

What is
this
technique?
https://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Click%20on%20image%20to%20zoom&p=PMC3&id=1126321_1449_f1.jpg
• This technique is based on the detection of radioactivity emitted after a small

amount of a radioactive tracer is injected into a peripheral vein.
▪ The tracer is administered as an intravenous injection usually labelled with

carbon-11, nitrogen-13 oxygen-15, or fluorine-18.
• The total radioactive dose is similar to the dose used in computed

tomography.
PET is a non-destructive imaging technique in nuclear
medicine with many unique properties such as:
https://images.app.goo.gl/diXbjyBNkXU3G7ak9
PET providing information on tissue biochemistry rather than anatomy (Paans et al., 2000; Cherry, 2001; Levin, 2005; Wang et al., 2005).
• The radiopharmaceutical is transported
throughout the body by the circulation and
taken up by target organs resulting in the
emission of externally detectable radiation.
• The emitted radiation is measured by a PET

camera and used for imaging.
• The radiopharmaceuticals which are used in

PET are marked with radionuclides which
decay by the emission of positrons (Fig). Fig: Radioactive decay of “C and positron annihilation,
(Waarde, 2012).
• Positrons are anti-electrons, i.e. particles with the same mass as an electron
but a positive instead of a negative charge.
• This form of radioactive decay is important both for image reconstruction and
for the interpretation of PET images.
• A PET camera does not detect the positrons
themselves for their range of travel within tissue is
too short (less than 2.5 mm).
• The camera detects the two gamma quanta which

originate from the annihilation of these anti-
electrons.
• When a positron meets a normal electron, the

combined mass of the two particles is converted to
energy in a process that is called annihilation. Fig: Radioactive decay of “C and positron annihilation, (Waarde, 2012).
• Annihilation of a positron results in the formation of two 511 kev photons which are emitted in
anti-parallel (i.E. Approximately 180 degrees opposite) directions (fig).
• These high-energy photons leave the body and are counted by detectors in the pet camera.
• Electronic circuits connected to the detector rings ensure that events are only registered when
two detectors are (virtually) simultaneously hit by a photon.
▪ The radionuclides which are commonly used in PET have very short half-lives (11C: 20
minutes, 13N: ten minutes, 15O: two minutes, 18F: 109.8 minutes, respectively).
▪ Transport of carbon-11, nitrogen-13 and oxygen-15 over large distances is therefore
impossible.
▪ Such radionuclides should be produced locally.
▪ 11C, 13N, 15O and 18F are made by nuclear reactions (Below Table).
▪ 11C, for example, is made by irradiating nitrogen gas with protons.
▪ Protons of the right energy evoke the following nuclear reaction 14N (p,α) 11C
Table: Radionuclides for PET

https://images.app.goo.gl/hnEFrHGe6cHz1Lzq6
The scanning protocol proceeds

in a number of logical steps:
(1) production of radioactivity;
(2) preparation of the desired radiopharmaceutical;
(3) purification, sterilization and quality control;
(4) administration of the tracer to the experimental
animal or the human subject;
(5) data acquisition;
(6) image reconstruction;
(7) analysis of the data with tracer-kinetic models;
and
(8) reporting to the investigator or the physician of the
patient.
https://youtu.be/oySvkmezdo0
Fig: Diagrammatic representation of the process of PET technique.
https://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Click%20on%20image%20to%20zoom&p=PMC3&id=1126321_1449_f2.jpg
In general, PET scans may be used to evaluate organs and/or
tissues for the presence of disease or other conditions.
More specific reasons for PET scans include, but are not limited
to, the following:
Fig: PET scans of the brain for

To diagnose dementias (conditions that involve deterioration of Alzheimer's disease
mental function), such as Alzheimer's disease, as well as other A PET scan can compare a normal brain (left) with one
affected by Alzheimer's disease (right). The loss of red
neurological conditions such as: color with an increase in yellow, blue and green colors
shows areas of decreased metabolic activity in the brain
due to Alzheimer's disease.
https://www.mayoclinic.org/-/media/kcms/gbs/patient-
consumer/images/2014/05/04/08/38/mcdc7_pet_scan_alzheimers.jpg
Parkinson's disease: A progressive disease of the nervous system
in which a fine tremor, muscle weakness, and a peculiar type of
gait are seen.
Fig: PET scans of a (a) normal brain and (b) brain with
Parkinson disease.
Huntington's disease: A hereditary disease of the nervous

system which causes increasing dementia, bizarre involuntary
movements, and abnormal posture.
https://images.app.goo.gl/DTUTa2TFDQEQUgvB8
https://images.app.goo.gl/MsA8acVuW3nk1C8s6
PET is used to study the brain and heart. Fig: PET scan of the heart
This PET image shows an area of reduced blood flow
from one of the arteries that feeds the heart. This
information may help doctors decide whether to
suggest bypass surgery or angioplasty to restore that
It is used to locate the origin of epileptic blood flow.

https://www.mayoclinic.org/-/media/kcms/gbs/patient-consumer/images/2013/08/26/10/03/my00238_im03976_mcdc_pet_heartthu_jpg.jpg
activity in the brain.
It is also used to detect tumours.

Fig: Cancer (Brain Tumor)
https://images.app.goo.gl/cxRorBnziNANT6vW6
It is also used to study the mental health problems such as depression.

PET scans take 10-40 minutes to complete. They are painless, and, as for
computed tomography, the patient is fully clothed.
PET helps to visualize the biochemical changes taking place in the body, such as the metabolism (the process by
which cells change food into energy after food is digested and absorbed into the blood) of the heart muscle.
A common use for PET is to measure the rate of consumption of glucose in different parts of the body.
Accumulation of the radiolabelled glucose analogue 18-fluorodeoxyglucose (FDG) allows measurement of the rate
of consumption of glucose. One clinical use of this is to distinguish between benign and malignant tumours
(malignant tumours metabolise glucose at a faster rate than benign tumours). Whole body scans are often
performed to stage a cancer.
https://images.app.goo.gl/3azZ2Rx9wRppmow27
Other applications of PET include looking at the blood flow and

oxygen consumption in different parts of the brain—for example,
in understanding strokes and dementia. Tracking chemical
neurotransmitters (such as dopamine, in Parkinson's disease) can
also be performed with this technique.
PET has further applications in cardiology (in pretransplantation

assessment of viable myocardium), in distinguishing recurrent
tumours from radiation necrosis and surgical scarring, and in a
variety of cancers.
(Source: Waarde, 2012)
• PET may also be used in conjunction with other
diagnostic tests, such as computed tomography (CT) or
magnetic resonance imaging (MRI) to provide more
definitive information about malignant (cancerous)
tumors and other lesions.
• Newer technology combines PET and CT into one
scanner, known as PET/CT. PET/CT shows particular
promise in the diagnosis and treatment of lung
cancer, evaluating epilepsy, Alzheimer's disease and Fig: PET plus CT
coronary artery disease. Combining a PET scan with an MRI or CT scan can help make the images
easier to interpret. At left is a CT scan, while the center image is a PET scan.
The image on the right is a combined PET-CT scan. The bright spot in the
chest, seen best on the PET and PET-CT scans is lung cancer.
Q: What is non-destructive imaging?
Ans:
Q: Pharmacokinetics meaning?
Ans:
Q: What is nuclear medicine?
Ans:
Q: Why do you need a PET scan?

Ans:
❑ Information for Patients - | University of Utah. (2020, October 22).
https://uofuhealth.utah.edu/huntsman/cqci/clinical-patient-imaging/information-for-patients.php
❑ PET Center | Radiology | Michigan Medicine. (2018, March 30). Radiology.
https://medicine.umich.edu/dept/radiology/research/pet-center
❑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1126321/
❑ PET scan. (n.d.). https://medlineplus.gov/ency/article/003827.htm
❑ Waarde, A. V. (2012). Introduction on PET: Description of Basics and Principles. Trends on the Role of PET in Drug
Development, 1–13. https://doi.org/10.1142/9789814317740_0001
❑ https://depts.washington.edu/imreslab/education/Physics%20of%20PET.pdf
❑ Berger A. (2003). How does it work? Positron emission tomography. BMJ (Clinical research ed.), 326(7404), 1449.
https://doi.org/10.1136/bmj.326.7404.1449
❑ Positron Emission Tomography (PET). (2021, August 20). Johns Hopkins Medicine, from
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/positron-emission-tomography-pet

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Saba Parvin Haque

Figure: Explanation of the term “positron emission tomography” (Waarde, 2012).

• This technique is based on the detection of radioactivity emitted after a small

▪ The tracer is administered as an intravenous injection usually labelled with

• The total radioactive dose is similar to the dose used in computed

• The emitted radiation is measured by a PET

• The radiopharmaceuticals which are used in

• The camera detects the two gamma quanta which

• When a positron meets a normal electron, the

▪ 11C, for example, is made by irradiating nitrogen gas with protons.

Table: Radionuclides for PET

The scanning protocol proceeds

Fig: PET scans of the brain for

Huntington's disease: A hereditary disease of the nervous

It is used to locate the origin of epileptic blood flow.

activity in the brain.

It is also used to detect tumours.

It is also used to study the mental health problems such as depression.

Other applications of PET include looking at the blood flow and

PET has further applications in cardiology (in pretransplantation

Q: Why do you need a PET scan?

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