ROJoson PEP Talk: PET Scan - What and When Indicated

ROJoson PEP Talk: PET Scan - What and When Indicated

1. July 14, 2024 1400H - 1500H Via Zoom PET Scan – What and When Indicated Empowerment objective - for laypeople to have an essential  understanding on PET Scan – What and When Indicated as part of their health management.

2. July 14, 2024 1400H - 1500H Via Zoom PET Scan – What and When Indicated Empowerment objective - for laypeople to have an essential  understanding on PET Scan – What and When Indicated as part of their health management. Welcome all! MUTE yourself but always show your video picture. Sign in your name, FB account, or email address in the Chat Box! Include names of companions attending. Use the Chat Box to ask questions and make comments while the PEP TALK is on. There will be group pictures at start and end of PEP TALK – show your face in video.

3. Reminder after the PEP Talk: Take the Online Learning cum Evaluation Test Exercise (OLETE) for mastery of learning and have a perfect score to get a Certificate. Link is in Chat Box.

4. Reminder: 25 OLETE Certificates = 1 Voucher for ROJoson Medical Consultation either Face-to-Face or Telemedical.

5. PET Scan – What and When Indicated Empowerment objective - for laypeople to have an essential  understanding on PET Scan – What and When Indicated as part of their health management. ROJOSON’S REQUEST: FEEDBACK TO THIS PEP TALK! Pls. type in your feedback in the chat box during the open forum and before we adjourn! Thank you!

6. PET Scan – What and When Indicated Empowerment objective - for laypeople to have an essential  understanding on PET Scan – What and When Indicated as part of their health management. LET’S NOW HAVE A GROUP PICTURE TAKING BEFORE WE START PEP TALK PROPER IN 2 MINUTES! Pls. turn on your video! Show your face!

7. PET Scan – What and When Indicated Empowerment objective - for laypeople to have an essential  understanding on PET Scan – What and When Indicated as part of their health management. ROJoson PEP Talk I have a Patient Empowerment Program in which I like to empower the lay people or patients to take control in the management of their health.

8. I started the PEP Talk on May 15, 2021 during the COVID19 Pandemic. There are 3 courses in the PEP Talk. I completed the Core Course on October 9, 2021.

9. From October 23, 2021 onwards, I have been tackling Health Disorder and Health Issue Courses. May 18, 2024 marks the start of YEAR 4 of ROJoson PEP Talk. How long the PEP Talk will last will depend on our enthusiasm , discipline and perseverance .

10. PET Scan – What and When Indicated Empowerment objective - for laypeople to have an essential  understanding on PET Scan – What and When Indicated as part of their health management. My PEP TALK today is entitled: PET Scan – What and When Indicated

11. x Contents What is a PET scan? What are the utility of a PET scan? What are differences between a PET scan, CT scan and MRI? What are considered low-value indications for PET scan or PET-CT scan? What are considered high-value indications for PET-scan or PET-CT scan? PET Scan – What and When Indicated Disclaimer: ROJoson PEP Talk contains ROJoson’s Thoughts, Perceptions, Opinions and Recommendations (TPORs) culled from experiences of ROJoson and writings of other health professionals.

12. d What is a PET scan? PET scan stands for POSITRON EMISSION TOMOGRAPHY (PET) scan. It is a laboratory diagnostic procedure. It is a kind of a diagnostic imaging procedure that makes detailed pictures of the inside of the human body. PET Scan – What and When Indicated

13. What is a PET scan? It uses a radioactive tracer drug to study the metabolic or biochemical function of the tissues and organs in the body. It most commonly uses a radiotracer called fluorodeoxyglucose (FDG) – a safe injectable [nuclear scan] It uses a PET scanner. The scanner detects diseased cells that absorb large amounts of the radiotracer, which indicates a potential health problem. PET Scan – What and When Indicated

14. What is a PET scan? PET scan stands for POSITRON EMISSION TOMOGRAPHY scan. It is a laboratory diagnostic procedure. It is a kind of a diagnostic imaging procedure that makes detailed pictures of the inside of the human body. It uses a radioactive tracer drug to study the metabolic or biochemical function of the tissues and organs in the body. PET Scan – What and When Indicated

15. PET Scan – What and When Indicated

16. PET Scan – What and When Indicated

17. ate How does a PET scan work? Diseased cells in your body absorb more of the radiotracer than healthy ones do. These are called “hot spots.” The PET scanner detects this radiation and produces images of the affected tissue. PET Scan – What and When Indicated

18. PET scan is commonly requested nowadays in the Philippines and its cost can range from 40K to 60K (as of 2024). Thus, it is important to know what PET scan is and what are its indications to avoid overuse or low-value use of it. Low-value medical care is defined as “little-to-no benefit to patients, is likely to cause more harm than benefit, and is too expensive given its benefits.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9808350/#:~:text=Low%2Dvalue%20care%20has%20been,too%20expensive%20given%20its%20benefits. PET Scan – What and When Indicated

19. Utility Positron emission tomography (PET) scans can detect early signs of cancer, heart disease and brain conditions. They have been used in: Cancer, including breast cancer, lung cancer and thyroid cancer Coronary artery disease, heart attack or other heart problems Brain disorders, such as brain tumors, epilepsy, dementia and Alzheimer’s disease PET Scan – What and When Indicated https://my.clevelandclinic.org/health/diagnostics/10123-pet-scan

20. Utility In general, a PET scan can measure vital functions, such as blood flow, oxygen use and blood sugar (glucose) metabolism. It can also identify organs and tissues that aren’t working as they should. PET Scan – What and When Indicated https://my.clevelandclinic.org/health/diagnostics/10123-pet-scan

21. Utility If your healthcare provider suspects you may have cancer, they’ll likely recommend a PET scan, which can detect cancer and/or make a diagnosis. PET Scan – What and When Indicated https://my.clevelandclinic.org/health/diagnostics/10123-pet-scan

22. Utility If you’ve already been diagnosed with cancer, your provider may recommend more than one PET scan throughout your treatment to: Determine whether the cancer has spread in your body (metastasized). [stage] Assess the effectiveness of treatment. Determine if the cancer has returned after treatment (recurred). Evaluate the prognosis (outlook) of the cancer. PET Scan – What and When Indicated https://my.clevelandclinic.org/health/diagnostics/10123-pet-scan

23. Utility If you’re having heart issues, your provider may recommend a PET scan to: Determine the effects of a heart attack on areas of your heart. Identify areas of the heart muscle that would benefit from angioplasty or coronary artery bypass surgery. PET Scan – What and When Indicated https://my.clevelandclinic.org/health/diagnostics/10123-pet-scan

24. Utility If you’re experiencing neurological symptoms, your provider may recommend a PET scan to evaluate possible brain abnormalities, such as tumors, seizures and other central nervous system conditions. PET Scan – What and When Indicated https://my.clevelandclinic.org/health/diagnostics/10123-pet-scan

25. Utility So, PET scans are commonly used to evaluate health issues involving CANCERS, HEART DISEASES AND BRAIN CONDITIONS. In the Philippines, PET scans are most commonly requested in cancer patients. From hereon, I will now focus my discussion on the (high-value) indications of PET scan in patients with cancers. PET Scan – What and When Indicated

26. ate Before going into the high-value indications for PET-scans ----- What are the differences between CT scan and MRI and PET scan? What is PET-CT scan? What is PET-MRI? PET Scan – What and When Indicated

27. ate What are the differences between CT scan and MRI and PET scan? Computed tomography (CT) scans use X-rays.  Magnetic resonance imaging (MRI) scans use magnets and radio waves. Both produce STILL images of organs and body structures. PET scans use a radioactive tracer to show how an organ is functioning in REAL time.  PET Scan – What and When Indicated

28. ate What are the differences between CT scan and MRI and PET scan? PET scan images can detect cellular changes in organs and tissues EARLIER than CT and MRI scans. PET Scan – What and When Indicated

29. ate PET Scan – What and When Indicated

30. ate What is PET-CT scan? What is PET-MRI? Your healthcare provider may perform a PET scan and CT scan at the same time (PET-CT). This combination test produces 3D images that allow for a more accurate diagnosis. Some hospitals now use a hybrid PET/MRI scan. This new technology creates extremely high-contrast images. Providers mainly use this type of scan for diagnosing and monitoring cancers of the soft tissues (brain, head and neck, liver and pelvis). PET Scan – What and When Indicated

31. ate What is PET-CT scan? What is PET-MRI? Your healthcare provider may perform a PET scan and CT scan at the same time (PET-CT). This combination test produces 3D images that allow for a more accurate diagnosis. Some hospitals now use a hybrid PET/MRI scan. This new technology creates extremely high-contrast images. Providers mainly use this type of scan for diagnosing and monitoring cancers of the soft tissues (brain, head and neck, liver and pelvis). PET Scan – What and When Indicated PET Scan CT Scan PET-CT Scan

32. ate Why PET-CT scan is preferred over PET scan alone or over CT scan or over MRI scan? PROs and CONs PET scans can detect areas of cancer that may not be large enough to show up on a CT or MRI scan. However, PET scan images are not as sharp as those produced by CT or MRI. PET Scan – What and When Indicated

33. ate Why PET-CT scan is preferred over PET scan alone or over CT scan or over MRI scan? PROs and CONs PET scans identify areas where the cells are highly active, but since they don’t show all structures (anatomy) clearly, it is difficult to identify the exact structure where the suspicious cells are located. To solve this problem, combination PET and CT scan is preferred that’s more accurate than either test on its own. The CT images clearly show the structures/anatomy. The PET images are combined with the CT images. Using this technique, when cancer cells "light up" on the PET scan, the physician can tell where they are located. PET Scan – What and When Indicated

34. ate What are the low-value indications for PET-CT scan in cancer patients? Low-value indication: if PET-CT scan is ROUTINELY used to detect and diagnose solid cancers. There are other cost-effective diagnostic imaging procedures that can be used, at least as a starter. Examples: Ultrasound; CT-scan; MRI; others (accurate enough and cheaper) PET Scan – What and When Indicated Low-value medical care is defined as “little-to-no benefit to patients, is likely to cause more harm than benefit, and is too expensive given its benefits.”

35. ate What are the low-value indications for PET-CT scan in cancer patients? Low-value indication: if PET-CT scan is ROUTINELY used to determine whether the cancer has spread or has metastasized. (stage). There are other cost-effective diagnostic imaging procedures that can be used, at least as a starter. Examples: Ultrasound; CT-scan; MRI; others (accurate enough and cheaper) PET Scan – What and When Indicated Low-value medical care is defined as “little-to-no benefit to patients, is likely to cause more harm than benefit, and is too expensive given its benefits.”

36. ate What are the low-value indications for PET-CT scan in cancer patients? Low-value indication: if PET-CT scan is ROUTINELY used to assess the effectiveness of treatment. There are other cost-effective diagnostic imaging procedures that can be used, at least as a starter. Examples: Ultrasound; CT-scan; MRI; others (accurate enough and cheaper) PET Scan – What and When Indicated Low-value medical care is defined as “little-to-no benefit to patients, is likely to cause more harm than benefit, and is too expensive given its benefits.”

37. ate What are the low-value indications for PET-CT scan in cancer patients? Low-value indication: if PET-CT scan is ROUTINELY used to determine if the cancer has returned after treatment (recurred). There are other cost-effective diagnostic imaging procedures that can be used, at least as a starter. Examples: Ultrasound; CT-scan; MRI; others (accurate enough and cheaper) PET Scan – What and When Indicated Low-value medical care is defined as “little-to-no benefit to patients, is likely to cause more harm than benefit, and is too expensive given its benefits.”

38. ate What are the high-value indications for PET-CT scan in cancer patients? PET imaging is typically considered after other techniques provide inconclusive or discordant results, such as computed tomography (CT), magnetic resonance imaging (MRI), or ultrasonography. PET Scan – What and When Indicated Low-value medical care is defined as “little-to-no benefit to patients, is likely to cause more harm than benefit, and is too expensive given its benefits.”

39. ate What are the high-value indications for PET-CT scan in cancer patients? PET imaging is considered if it will change the health outcomes with a good quality of life. PET imaging is considered if the treatment will be markedly changed if one is done. PET Scan – What and When Indicated Low-value medical care is defined as “little-to-no benefit to patients, is likely to cause more harm than benefit, and is too expensive given its benefits.”

40. ate What are the high-value indications for PET-CT scan in cancer patients? Various medical societies and organizations have come out with guidelines on the use of PET-CT scans. These guidelines can be considered. PET Scan – What and When Indicated Low-value medical care is defined as “little-to-no benefit to patients, is likely to cause more harm than benefit, and is too expensive given its benefits.”

41. ate What are the high-value indications for PET-CT scan in cancer patients? Examples of guidelines: Breast Cancer PET imaging meets the definition of medical necessity in the staging or restaging of breast cancer for the following: Detecting locoregional or distant recurrence or metastasis (except axillary lymph nodes) when suspicion of disease is high and other imaging is inconclusive. PET Scan – What and When Indicated

42. ate What are the high-value indications for PET-CT scan in cancer patients? Examples of guidelines: PET imaging for breast cancer is considered experimental or investigational for the following. The evidence is insufficient to determine that PET imaging results in an improvement in health outcomes. Differential diagnosis with suspicious breast lesions or an indeterminate/low suspicion finding on mammography Predicting pathologic response to neoadjuvant therapy for locally advanced disease Staging of axillary lymph nodes. PET Scan – What and When Indicated

43. Summary Take Away PET Scan – What and When Indicated Contents What is a PET scan? What are the utility of a PET scan? What are differences between a PET scan, CT scan and MRI? What are considered low-value indications for PET scan or PET-CT scan? What are considered high-value indications for PET-scan or PET-CT scan?

44. Summary Take Away PET Scan – What and When Indicated What are considered low-value indications for PET scan or PET-CT scan? ROUTINELY DONE without consideration of other diagnostic imaging procedures that are as accurate and cheaper. DOES not change the health outcomes and quality of life.

45. Summary Take Away PET Scan – What and When Indicated What are considered high-value indications for PET-scan or PET-CT scan? Considered after other techniques provide inconclusive or discordant results, such as computed tomography (CT), magnetic resonance imaging (MRI), or ultrasonography. Considered if it will change the health outcomes with a good quality of life. Considered if the treatment will be markedly changed if one is done.

46. Take Away in relation to Patient Empowerment Be always in touch with reliable medical information on PET Scan – What and When Indicated. Knowledge is power; it gives power. Use the 4Ks of Patient Empowerment: Kaalaman , Kakayanan , Karapatan and Kapangyarihan to gain greater control over decisions / make better decisions on PET Scan – What and When Indicated as part of your health management. PET Scan – What and When Indicated

47. PET Scan – What and When Indicated Empowerment objective - for laypeople to have an essential  understanding on PET Scan – What and When Indicated as part of their health management. This ends m y PEP TALK today on: PET Scan – What and When Indicated

48. Reminder after the PEP Talk: Take the Online Learning cum Evaluation Test Exercise (OLETE) for mastery of learning and have a perfect score to get a Certificate. Link is in Chat Box.

49. Reminder: 25 OLETE Certificates = 1 Voucher for ROJoson Medical Consultation either Face-to-Face or Telemedical.

50. PET Scan – What and When Indicated Empowerment objective - for laypeople to have an essential  understanding on PET Scan – What and When Indicated as part of their health management. ROJOSON’S REQUEST: FEEDBACK TO THIS PEP TALK! Pls. type in your feedback in the chat box during the open forum and before we adjourn! Thank you!

51. PET Scan – What and When Indicated Empowerment objective - for laypeople to have an essential  understanding on PET Scan – What and When Indicated as part of their health management. LET’S NOW HAVE A GROUP PICTURE TAKING BEFORE WE START Q&A AND INTERACTIONS! Pls. turn on your video! Show your face!