New England Pet Imaging System

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24 Years

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(978) 689-4738Call Visit WebsiteVisit Website Map & DirectionsDirections70 East StMethuen, MA 01844 Write a ReviewWrite Review

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Mon - Fri:	9:00 am - 5:00 pm

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Phone: (978) 794-4747

Fax: (978) 682-0984

TollFree: (888) 560-4738

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http://www.nepetimaging.com

http://nepetimaging.com/contact.html

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Medical Imaging Services, Mammography Centers, Physicians & Surgeons, Radiology

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Phone: (978) 689-4738

Address: 70 East St, Methuen, MA 01844

Website: http://www.nepetimaging.com

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New England Pet Imaging System

General Practitioners

Emergency Care
When you enter the property of the Merrimack Valley Hospital, follow the hospital signs to the Emergency Room. You will enter through there and a PET employee will be ready to greet you.
Colonoscopy
This case involves an 82-year-old female who presented with massive rectal bleeding. A mass was found in her right transverse colon by colonoscopy. Pre-op CT revealed a soft tissue mass in the presacral area (arrow, CT Figure 1). The liver was reported as unremarkable on CT scan (CT Figures 2 and 3). The patient underwent colectomy and eight out of nine nodes were positive for metastases. A whole-body PET-FDG scan was requested for further evaluation.

Cervical Cancer
In the detection of para-aortic lymph node metastasis, FDG-PET imaging has a sensitivity of 85.7%, a specificity of 94.4%, and an accuracy of 92%. When abdominal CT findings are negative, the use of FDG-PET can accurately detect para-aortic lymph nodal metastasis in patients with advanced cervical cancer(1).
Colon Cancer
Prostate Cancer
18 F-Sodium Fluoride (NaF) PET/CT is an important tool for detecting and evaluating metastatic bone cancer. These studies are particularly useful, since some of the most prevalent cancers are commonly associated with metastatic bone disease, such as breast and prostate cancer, as well as carcinoma of the thyroid, kidney, and lung.
Cancer Care
PET/CTs received wide clinical acceptance for a variety of clinical applications in oncology (cancer care), cardiology, and neurology. This is further reflected in the Center for Medicare and Medicaid Services (CMS) ongoing expansion of Medicare coverage for PET/CT for the early detection, staging, and monitoring of disease.
Lung Cancer
An FDG-PET/CT staging study was performed within a week of the biopsy-proven diagnosis of small-cell lung cancer. The FDG-PET/CT study showed intense abnormal FDG uptake in the right paramediastinal mass and in the adjacent right upper lobe nodule. The study also revealed high uptake in lymphadenopathy in the right paratracheal, subcarinal, and suprasternal notch regions.

Neurology
Since opening in April 2000, New England PET Imaging System has provided PET and PET/CT services to patients with a variety of clinical needs in the areas of oncology, cardiology, and neurology.
Epilepsy
PET/CT is a useful tool in assessing neurologic activity within the brain. PET/CT may be used to characterize various dementias, such as Alzheimer’s Disease, as well to determine the focus of epilepsy seizures. PET/CT is also used in assessing certain cancers of the brain, to determine if there is recurrence of cancer rather than changes brought about by radiation therapy.

Endocrinologist

Diabetes Care

Ultrasound
This patient is a 72-year-old male who presented with anemia. Esophagogastroduodenoscopy (“EGD”) revealed esophageal tumor extending from 29.0cm to 38.0cm. Endoesophageal ultrasound staged this as T3 N0 M0 carcinoma. CT scan revealed abnormality involving the distal esophagus. The plan was for radiation therapy combined with chemotherapy and then definitive surgery.
MRI
A 27-year-old female presented with intractable complex partial seizure disorder for a period of three years. An MRI study of the brain was unremarkable and EEG was inconclusive. A PET FDG scan was requested for further evaluation and was performed as an interictal study.
Radiology
All New England PET sites are accredited by the American College of Radiology (ACR). The ACR, headquartered in Reston, VA, awards accreditation to facilities for the achievement of high practice standards after a peer-review evaluation of the practice. Evaluations are conducted by board-certified physicians and medical physicists who are experts in the field.
X-Rays
Nuclear Medicine
PET is a nuclear medicine imaging test in which a “radiopharmaceutical” is injected into patients to obtain images that show metabolic process within the body. We generally use the radiopharmaceutical FDG (Fluordeoxyglucose), which is a radioactive form of glucose, or sugar, with a half-life of about 110 minutes. The FDG travels throughout the patient’s body, emitting positively charged electrons, known as “positrons”, as it decays. These positrons move through tissue for several millimeters before colliding with electrons. This collision produces “photons” which are sent out at a direction of 180 degrees.
Computed Tomography
The patient is a 69-year-old woman with a history of axillary lymphadenopathy. Following a CT scan in December 2009, an excisional biopsy was recommended and conducted in early January 2010. Pathology results of the right axillary lymph node indicated a diagnosis of diffuse large B-Cell lymphoma.
Chemotherapy
An FDG-PET/CT was ordered to evaluate extent of disease and was performed in late January 2010. The PET/CT showed abnormal hypermetabolic activity within multiple lymph nodes in the neck, axillae, mediastinum, upper abdomen, retroperitoneum, pelvis, and inguinal regions, consistent with patient’s history of lymphoma (Figure 1). The PET/CT also showed diffuse uptake in the right breast and axilla from lymphedema and post-surgical changes. The patient received three cycles of chemotherapy followed by a PET/CT two weeks after completion of chemotherapy to assess response.
Radiation Therapy
For many tumor types, PET/CT offers better specificity and sensitivity in both diagnosis and staging compared with the use of CT alone. A recent article reports a 27% change in patient management due to changes in staging when PET/CT is included in radiation therapy planning. Precise delineation of target or tumor volume and vital structures is extremely important for the radiation oncologist to deliver precise radiation therapy to the malignancy with maximum protection of the vital structure. With the adjunct of PET/CT to radiation therapy planning, dose escalation is possible with an improvement of cure rate and the reduction of side effects to the normal structures. Anatomic imaging as provided by CT is limited when distortion of normal anatomy occurs because of prior surgery, radiation, or other image artifacts such as a dental filling.
Radiation Oncology
By Santos Shetty, M.D., Med. Dir., Radiation Oncology, Caritas Holy Family Hospital, and Robert C. Hannon, M.D., Med. Dir., New England PET Imaging System at Caritas Holy Family Hospital

Skin Cancer
The patient in this case is a 39-year-old male who had a melanoma in the left anterior chest wall and metastasis to the left axilla. He then underwent melanoma resection and axillary node dissection. His initial staging was Stage III. The patient is at high risk for local regional and systemic recurrence. One-and-a-half months after surgical treatment, the patient was seen by a radiation oncologist for possible postoperative adjuvant radiation therapy. A PET scan was ordered for staging the patient.
Lesions
FDG-PET demonstrated a focus of intense uptake corresponding to the presacral mass seen on CT (PET Figure 1). This is likely related to metastasis. In addition, there are at least two foci of intense uptake seen in the liver, consistent with metastases (PET Figures 2 and 3). In retrospect, and in light of the PET, there were subtle low attenuation lesions that were not easily seen on CT (arrows, CT Figures 2 and 3).

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