DOCTORS’ CORNER

HOW DO I REQUEST A PET SCAN?

    1. Please complete the Cape PET/CT request form, available for download on this link. Alternatively, you may request a booklet / electronic editable copy from our office.
    2. Please complete the form as thoroughly as possible.  We use it to obtain medical aid authorisation and when reporting the scan. 
  • An in depth clinical history is key, please include:
  • Clear indication/reason for referral
  • Current symptoms
  • Date of diagnosis
  • Type of histology and report 
  • Previous treatment history including:
    • Chemotherapy including date of last dose
    • Radiotherapy including area and date completed
    • Whether granulocyte stimulating colony factor was given and the date of the last dose
    • Surgery area and date
  • Previous surgeries unrelated to the condition that may influence our scan interpretation such as recent ORIF for a fracture, joint replacements etc.
  • Previous imaging findings and reports

Although all patients are seen by one of the attending doctors at time of the PET/CT, patients often do not know their complete history.

    1. You can send the request form to info@petct.co.za
  • We will send the form to the medical aid to obtain authorisation. 
  1. If the patient is on the oncology benefit, the medical aid authorisation usually takes 3-5 working days, but this can depend on the medical aid or the indication for the scan. Further documents are often requested by the medical aid or the request is sent to the clinical advisor of the medical aid – this may cause a delay in authorisation.

This emphasises the importance of completing an in depth clinical history including attachments of histology reports, radiology reports and other relevant procedures.

    1. If a patient is NOT on a medical aid, and they would like to pay cash for the investigation, please state this on the request form. A quote can be obtained and our accounts department will liaise with the patient regarding payment terms and conditions (if applicable).  
    2. Preferably do not schedule any other appointments for your patient on the same day as the PET/CT scan. There are often unforeseeable delays and times are just a guideline.
  • When scheduling a follow-up appointment with the patient to review the PET/CT scan results, please do not schedule the appointment on the same day or too early the following day. The report will only be available after 12h00 the workday following the PET/CT scan.
  • The report will be sent via email or faxed to the referring physician. The result of the scan will not be discussed with the patient at the Cape PET/CT centre.
  1. Images will be sent to the PACS system of the referring radiology practice. If this is not possible, the patient will have a copy of the images on a disc. The disc has FUSED AXIAL and CORONAL slices as well as a viewing tool for your convenience.
  2. If DICOM data is needed for CT planning, please request a disc from our department. You may also request an electronic transfer of the images.  All images are stored for future reference.

 

Please do not hesitate to contact us at any time at the Cape PET/CT centre for more info.

 

How long should I wait after treatment before requesting a PET/CT?

Certain guidelines have been set-up to reduce false-positive and false-negative findings on a PET/CT.

It is therefore advisable to wait to following time-period after therapy:

    • Chemotherapy: 
      • For interim PET/CT restaging (lymphoma): 2 weeks
      • For end-of therapy restaging (lymphoma): 4-6 weeks
  • For other malignancies: 2-4 weeks
  • Colony growth stimulating factor/Neupogen: 10 days to 2 weeks from last injection
  • Radiotherapy: 3 months after the last treatment
  • Surgery:  at least 1 month 

We do understand that sometimes it is necessary to perform these scans before this time has passed If this is the case, please discuss this with one of the Cape PET/CT Nuclear Physicians at time of booking. 

 

My patient is scared of radiation: how can I explain this to them?

The radiation dose that we use is fairly small. We strictly adhere to the ALARA principal, which stands for “As low as reasonably achievable”. We thus try to obtain an image that is of sufficient quality for interpretation at lowest possible radiation dose to the patient.

All doses are carefully calculated for each patient according to their weight. In addition, newer technology has allowed us to reduce the injected dose required for imaging when compared to older scanners, thereby also reducing the radiation exposure to the patient.

Please refer to the article on Radiation exposure in everyday which can be found using the following hyperlink:  https://www.iaea.org/Publications/Factsheets/English/radlife for further information.

 

What types of diseases can be imaged with F-18 FDG PET/CT?

Most of the patients undergoing a PET/CT scan is patients that have already been diagnosed with cancer. In oncology this modality can be used for staging, restaging, detecting recurrences, follow-up/surveillance, response assessment and even radiotherapy planning. It can also be used in primaries of unknown origin, when all investigations have been unable to detect the primary, PET/CT has been shown to detect primary tumours in up to 50 % of these patients. 

Although most of our patients are oncology patients, PET/CT is also very useful in imaging infection and inflammatory conditions amongst other indications. Some of these include investigation of fever of unknown origin, to diagnose and monitor treatment of large vessel vasculitis (e.g. Takayasu’s arteritis), assessment of a prosthetic valve infection or suspected vascular graft infection, in assessment and therapy monitoring in cardiac sarcoidosis and even in to detect viable myocardium in patients with ischaemic heart disease.

 

Please follow this link to download the recently published list of indications for a PET/CT.