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Description of the study

Positron emission tomography (PET-CT)

Positron Emission Tomography (PET), combined with computed tomography (CT), is one of the most effective methods of diagnostic imaging, used primarily in oncology, as well as in certain cardiac and neurological conditions.

This innovative method enables the precise determination of the location and stage of cancer, the identification of the primary tumour, and the assessment of any recurrence of the disease. PET-guided treatment facilitates the assessment of the effectiveness of radiotherapy or chemotherapy. In the case of certain cancers, it enables a definitive diagnosis to be made, which can sometimes be difficult using other imaging techniques. In addition, PET-CT scans are used in the diagnosis of inflammatory conditions: inflammatory bowel disease and vasculitis.

Outside the field of oncology, PET is mainly used for brain scans, including the diagnosis of neurodegenerative disorders such as Alzheimer’s and Parkinson’s diseases, as well as various forms of schizophrenia and epilepsy. PET also enables the early diagnosis of Huntington’s disease, the monitoring of myocardial metabolism – including the assessment of myocardial viability – as well as cardiovascular conditions and inflammatory conditions of unknown origin.

During the examination, a PET scan of the patient’s body is performed, showing the uptake of the tracer previously administered to the patient, alongside a CT scan, which visualises the body’s anatomical structures. The combination of these two methods – PET and CT – allows for a very accurate assessment of metabolic changes occurring within cells, as well as the identification of lesions and the precise determination of their location.

A PET scan makes use of the fact that certain pathological changes are accompanied by alterations in the metabolism of specific chemical compounds. The patient is given an intravenous injection of a substance known as a radiopharmaceutical; this is most commonly fluorodeoxyglucose labelled with the fluorine-18 isotope (18F-FDG), which has a short half-life, ensuring that the radiation dose is safe.

The metabolism of fluorodeoxyglucose is identical to that of glucose in the body and is elevated in cancer cells, which makes it possible to localise diseased tissues even before subtle structural changes become visible. All Voxel centres use their own supplies of FDG, produced at the Radiopharmaceutical Production Centre in Kraków, which ensures rapid distribution of the preparation within a few hours of its production.


Types of PET-CT scans

Oncological PET-CT (using the radioactive isotope 18F-fluorodeoxyglucose (FDG)) The cost of the scan is reimbursed subject to criteria strictly defined by the National Health Fund (NFZ):

  • Lung nodule (with a diameter of > 1 cm)
  • Non-small cell lung cancer
  • Hodgkin’s lymphoma and non-Hodgkin’s lymphomas
  • Colorectal cancer
  • Oesophageal cancer
  • Assessment of a pathological lesion raising suspicion of cancer located in the pancreas or liver
  • Breast cancer
  • Cervical and endometrial cancer
  • Melanoma
  • Ovarian cancer
  • Epithelial tumours of the head and neck
  • Malignant brain tumours
  • Thyroid cancer
  • Suspected bone metastases
  • Planning radical radiotherapy
  • Testicular tumours (excluding mature teratomas)

Oncological choline (labelled with fluorine-18, 18F-fluorocholine):

  • Kidney cancer
  • Prostate cancer
  • Hyperparathyroidism

Neurological PET-CT:

  • Diagnosed drug-resistant epilepsy
  • paraneoplastic syndromes in patients with neurological disorders, i.e. autoimmune and limbic encephalitis, cerebellitis, Journal of Laws – 5 – Item 785 polyneuropathy, where cancer is suspected but the results of previous investigations (CT, MRI, EEG) do not allow the primary tumour site to be localised – tracer: [18F]FDG

Cardiac PET-CT:

  • Suspected ischaemic disease
  • Research into assessing myocardial viability.

Inflammatory processes:

  • Diagnosis of infective endocarditis affecting prosthetic or native valves, or associated with a CIED
  • diagnosis of inflammation of the walls of large blood vessels; suspected Takayasu’s disease or giant-cell arteritis

Hyperparathyroidism:

  • hyperparathyroidism

Preparing for a PET scan – 18F fluorodeoxyglucose (FDG)

General recommendations

Diet

24 hours before your scheduled examination:

  • We recommend a low-carbohydrate diet, i.e. limiting your intake of sweets, fruit and juices.
  • You must not drink alcohol or drinks containing caffeine (i.e. coffee, tea, Coca-Cola).

You must not eat or chew gum for 6 hours before the scheduled appointment.
You should drink approximately 1–1.5 litres of still, unflavoured, unsweetened mineral water gradually.

Physical activity

You should avoid strenuous physical activity (e.g. sports, heavy physical labour) for at least 24 hours beforehand

Other recommendations

If you have a cold, are taking antibiotics or steroid medication, have recently had an infection, are undergoing radiotherapy or chemotherapy, have had surgery, or find yourself in a situation that prevents you from attending your appointment on the scheduled date – please contact the centre where the examination is to be carried out.

On the day of the examination, you should wear comfortable, warm clothing (due to the air conditioning) that is free from metal parts (e.g. underwires, zips, etc.)

Recommendations for people with diabetes

Medicines

Before the test, the patient should inform the medical staff about any medication they are taking and their blood sugar level. If the test is carried out after 12:00, it is recommended that the patient eat a light breakfast and take their usual diabetes medication.

Meals

You must not eat anything or take insulin for 4 hours prior to the test (further details will be provided when you book your appointment). You may only drink still, unsweetened water. If you are taking insulin, please contact the centre before the test.

Blood sugar level

Your blood sugar level will be measured before the test. It is very important that your blood sugar level is stable before the test. Excessively high blood sugar levels can lead to errors in the test results and often make it impossible to carry out the test.
If your blood sugar level is too high (hyperglycaemia), the test may be cancelled or rescheduled for a later date when your blood sugar has returned to normal.


Indications and contraindications

Indications for PET-CT scans

PET-CT scans are mainly used in the diagnosis of cancer, as well as in certain cardiac and neurological conditions.

The test is reimbursed by the National Health Fund (NFZ) in strictly defined cases as set out on the referral form Download the referral form PDF. For other clinical indications, a PET-CT scan may be carried out at the patient’s own expense.

In oncology, the test enables:

Early detection of cancerous lesions

Assessment of the stage of cancer

Precise treatment planning

Treatment monitoring

Early assessment of treatment efficacy

The earliest detection of cancer recurrence

Contraindications to PET-CT scans


Documents

What should you bring with you to the appointment?

  • Photo ID document
  • The original referral form for the examination, legibly completed by the doctor and bearing their signature and stamp, provided that the referral has not already been submitted electronically
  • A complete set of your medical records, including the results of previous tests, such as CDs and hospital discharge summaries
  • Approximately 1.5 litres of still mineral water, to be drunk at the resort in accordance with the staff’s instructions.

Remember!

If the examination is to be carried out under the National Health Fund (NFZ), the original referral must be submitted to the clinic 14 days before the scheduled date of the examination. This requirement applies only to paper referrals. It does not apply to e-referrals.

Please note that you can also register for badanie online.

Download: Skierowanie na badanie PET-TK NFZ ( PDF )

Download: Ankieta – Karta wewnętrzna przed badaniem PET-TK ( PDF )

Download: Przygotowania do badania PET/TK ( PDF )

Download: PET z użyciem analogu somatostatyny ( PDF )

Download: Przygotowania do badań kardiologicznego PET/TK FDG ( PDF )


The course of the study

What does a PET-CT scan involve?

Before the examination

  • Please arrive for your examination 15 minutes before your scheduled appointment time to complete a medical questionnaire regarding any chronic conditions, allergies, medication you are taking and any possible contraindications to the examination.
  • Przed badaniem lekarz rozmawia z pacjentem i omawia procedury badania
  • The nurse inserts an intravenous cannula through which the radiopharmaceutical will be administered and measures the blood sugar level by pricking the finger. The intravenous cannula will be removed once the examination is complete

The administration of the isotope is painless and does not cause any noticeable side effects.
Due to the administration of the radiopharmaceutical and the associated radiation, patients should attend the examination unaccompanied, unless their medical condition requires the presence of a companion.

  • After the radiopharmaceutical has been administered, the patient rests for approximately 1 hour to allow the isotope to be distributed throughout the body. During this time, all physical activity, including speaking, should be minimised. Reading is also not permitted during this period. We should minimise the use of the laryngeal and eye muscles during this time.
  • Immediately before the examination, please use the toilet to empty your bladder.
  • After about 1 hour, a PET-CT scan is carried out.

Survey

  • The patient proceeds to the room where the imaging takes place
  • The patient lies down on the bed, usually on their back (unless there are any contraindications)
  • The scan takes about 20 minutes, during which the patient must lie completely still, as any movement of the body may cause errors in the images obtained (artifacts)
  • A technician, a doctor and a nurse are on hand to look after the patient, and any instructions are given via a microphone

After the examination

  • Before leaving the PET-CT Scanning Suite, please use the toilet to empty your bladder.
  • The administration of the radiotracer does not adversely affect the patient’s well-being; therefore, after the examination, the patient should feel well and may leave the centre and resume their normal activities and diet.
  • This radiopharmaceutical does not affect the ability to drive or operate machinery or vehicles.
  • For 12 hours, you should keep your distance when in contact with children, young people and pregnant women.
  • Over the next few hours, you should drink plenty of fluids so that the part of the radiopharmaceutical remaining in your blood is excreted in your urine as quickly as possible; observe good hygiene, and in particular: flush the toilet twice, and thoroughly wipe away any urine with a separate piece of toilet paper, which should be disposed of in the toilet and flushed, after each visit to the toilet. Wash your hands thoroughly under running water to remove any traces of the radioisotope.

Collection of results

At reception, the patient will be informed of the date on which they can collect their test results, which are sent to our specialists for interpretation and consultation. Results can be collected in person or by another person, provided the relevant authorisation form has been completed. The results consist of a medical report and a disc containing the PET-CT images along with the accompanying description.

The results of the PET-CT scan are not available online.


Available branches

The test can be carried out at the following centres: