The rise of PET/CT: 5 predictions for the future of hybrid imaging

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The addition of combination PET/CT examinations to the radiologist’s toolbox represents one of the most significant advancements in oncological imaging in the past decade.

So what does the future hold for hybrid imaging?

That’s the question Felipe de Galiza Barbosa, MD, and his colleagues at the University of Zurich in Switzerland set out to answer in a literature review, the results of which were recently published in the journal  Clinical Radiology.

“The clinical potential for PET/CT arguably remains unfulfilled,” they wrote. “Current developments in detector technology that allow for faster scans with significantly reduced injected tracer doses, open up new indications for PET imaging.”

They conducted a review of existing literature and explored possible advancements in the future of hybrid imaging, including the following five predictions:

  1. Reduced exposure to radiation: As was the case in the past decade, innovations in PET technology will further improve detector design and architecture to reduce patient exposure by as much as 50 percent, while a new generation of ultra-low-dose CT detectors will significantly reduce dosages and preserve image quality.
  2. Shorter scanning times: In the coming years, these same technological advancements will allow for non-contrast-enhanced image acquisition and improved post-processing, which will not only result in radiation dose reductions but will also shorten the time necessary for image acquisition.
  3. Partial body scans: Shorter scanning times and substantial reductions in patient exposure to radiation thanks to technological developments will open the door for partial body PET/CT examinations rather than current whole-body scanning standards.
  4. New indications: As future hybrid imaging systems advance, new clinical indications will emerge, particularly in the area of breast imaging, with recent studies already revealing the improved utility of PET/CT mammography over MRI mammography. Certain musculoskeletal and vascular indications could also emerge for hybrid imaging.
  5. Specialized tracers: While FDG remains the standard for PET tracers, specialized compounds like amino acid tracers for brain tumor imaging and receptor-specific peptides have already begun to be utilized in advanced hybrid imaging. These new theranositc ligands will increase clinical demand for PET/CT and help diagnose diseases not otherwise able to be targeted with standard imaging.

While it’s impossible to forsee the future, Barbosa and his fellow researchers believe things are just getting started for PET/CT and hybrid imaging.

“Major technical and clinical advances that are currently taking place in PET/CT ...  will potentially maintain the position of hybrid techniques at the forefront of medical imaging technologies,” they wrote. “PET/CT and hybrid imaging, in general, is likely to gain even more momentum in clinical use and increased accessibility and usability is expected internationally, even in countries with currently limited PET imaging.”