Nuclear Medicine

Body FDG-PET imaging is indicated for evaluation of a variety of proven or suspected malignant neoplasms for addressing the following clinical problems:

  • differentiation of benign from malignant lesions
  • staging and restaging of malignancies
  • assessment of response to therapy and detection of residual or recurrent tumor following therapy

For those not familiar with PET, the Society of Nuclear Medicine page on "What is PET? and their included links are useful.   In all cases,  PET  is indicated only if the study is likely to change clinical management. 

Post-therapy studies to assess for residual tumor should be delayed for approximately 2 months following completion of chemotherapy or radiotherapy, if possible.

To schedule an oncologic PET study, call our PET scheduling desk at 362-4PET (362-4738) or 888-362-4PET (888-362-4738) to obtain a study date and time, and then fax a completed Physician PET Request Form (available in our Scheduling forms section) to 314-362-1032.   After review of the form, you may be contacted to obtain additional information, if needed.

For patient preparation, see the PET patient information  section above.    If patient is diabetic, discuss with a nuclear medicine physician for further instructions. Drinking water and taking medications (except for insulin and oral hypoglycemic agents) are acceptable.

Note that a minimum fasting interval of 4 hours is recommended before the study (consult nuclear medicine physician if patient is diabetic).  Post-therapy studies to assess for residual tumor should be delayed for approximately 4 weeks after completion of chemotherapy or and for approximately 12 weeks after completion of radiotherapy, if possible. 

Medicare has approved coverage for FDG-PET studies for many indications. For a more information, see the Scheduling forms  (page two of the outpatient forms deals with Medicare coverage). 

To schedule a brain PET study, call our scheduling desk at 362-4PET (362-4738) or 888-362-4PET (888-362-4738).   For patients undergoing evaluation for cognitive impairment/dementia, Medicare has very stringent requirements for PET coverage -- please carefully review and fill out the "Non-tumor Brain PET/CT" scheduling form" (available in our Scheduling forms section) which is designed to include all the requirements of the CMS decision memo.

Brain PET amyloid imaging
We now offer Amyvid (Florbetapir F 18) for the detection of brain amyloid plaque in persons suspected of having Alzheimer’s Disease and were the first to do so in Missouri. Amyvid is an injectable radioactive agent used with a PET scanner to detect and estimate beta-amyloid plaque content in patients experiencing cognitive decline. Clumps of beta-amyloid proteins called plaques are the hallmarks of AD. Although a positive scan does not confirm Alzheimer’s – a negative scan essentially rules out AD. A positive scan means moderate to frequent amounts of plaque consistent with the amount of plaque found in patients with AD was detected. A negative scan means few or no plaques were detected. Previously, only an autopsy provided visual confirmation of AD. Amyvid is used in conjunction with other diagnostic tools to diagnose Alzheimer’s.

Cardiac PET with F-18 fluorodeoxyglucose is indicated for the detection of viable myocardium in patients with coronary artery disease and impaired ventricular function.

To schedule a cardiac PET study, call our scheduling desk at 314-362-7418
Patient without known diabetes should remain NPO after midnight prior to the cardiac PET study.  Patients on oral diabetic medication should remain NPO after midnight but take their medication.  Patients with insulin insulin-dependent diabetes should adhere to their normal dietary and insulin schedule.