The clinical value of F-18-FDG detection with a dual-head coincidence camera: a review

Positron emission tomography (PET) has evolved into a technique that can ac curately determine the distribution of positron-emitting radionuclides, The addition of a coincidence detection mode to a standard dual-head detector system has resulted in the option of single-photon and annihilation coincid ence detection. This new device for imaging fluorine-18 2-fluoro-2-deoxy-D- glucose (F-18-FDG) accumulation in neoplasms became commercially available in 1994. Besides conventional low-energy imaging in the collimated single-p hoton mode, it offers a relatively inexpensive opportunity to perform uncol limated PET by switching to the coincidence acquisition mode. This review s ummarises the clinical value of F-18-FDG detection with a dual-head coincid ence camera in oncology. The results are compared with the overall results obtained using dedicated PET scanners. With respect to head and neck tumour s,F-18-FDG coincidence mode gamma camera imagine (CGI) yields results that are in agreement with those obtained with dedicated PET scanners. With rega rd to other malignancies, such as lung cancer, lymphoma and brain rumours, data in the literature are too scarce to draw any definite conclusions. In general, the results of F-18-FDG CGI in tumours > 15 mm seem to be comparab le to those obtained with dedicated PET scanners, whereas in tumours < 15 m m, the relative sensitivity of F-18-FDG CGI is approximately 80%. Using att enuation correction, the diagnostic yield of F-18-FDG CGI may increase. How ever, further clinical investigation is required to definitely establish it s value in staging primary disease, therapy monitoring and assessment of tu mour recurrence in clinical oncology.