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PET project at FMC BY MICHAEL MARIZCO Sun Staff Reporter 11/14/2002 A targeting device designed to pinpoint cancerous cells through nuclear medicine will be making the rounds in Flagstaff beginning Dec. 2. And, despite the fact the PET scan will serve Flagstaff Medical Center patients out of an 18-wheeler, the hospital's radiology team said the mobile targeting system is nothing at all like the mobile CT scans that roll through town on occasion. "This is for somebody who already has cancer; it's totally different," said Dr. Tim Brown, chief of the radiology team. Recently, the hospital was critical of mobile CT scan units for the unnecessary dosage of radiation given to patients screening themselves for undiagnosed cancers, tumors and growths. But the PET scan is one modality that makes a lot of sense, Brown said. The PET scan is the latest unit in the hospital's arsenal to detect cancer cells. Unlike traditional X-rays, CT scans, or MRIs, the PET scan is able to give doctors the exact location of cancerous cells, particularly in the lungs -- though without replacing any of the other machines. "There might be times when we have a CT scan here, an MRI over here, and the PET scan right here," gestured radiologist Dr. Edgar Clark. The PET (positron emission tomography) is able to capture the image of the slightest changes in a person's body. In a scanning procedure, patients receive an injection of glucose spiked with a radioisotope, Fluorine-18. When glucose enters the body, the sugar is reached for by three organs: the brain, the heart, and cancerous cells. "A cancer cell is hypermetabolic," said Clark. "It's grabbing glucose big-time." The positron emitted by Fluorine-18 strikes out in precise 180-degree lines when it reacts. It's that reaction that allows for the precision of the scan. With the patient lying down, the PET Scan is able to read the two vertical emissions from where the newly-injected glucose sits in the body. "Glucose feeds the fire," Brown said. "The scan is able to localize, very precisely, exactly where the cancerous cells are taking in the glucose." The result is an image of every location in the body where the glucose was drawn to. "If there's trouble, the scan lights up," said Clark. The scan can be used to target a cancer's spread, calculate blood flow rates and help provide information on neurologic diseases such as schizophrenia or Parkinson's. The hospital is using Alliance Imaging as its provider for the service. While PET Scan technology is almost 30 years old, the engine behind molecular medicine, the cyclotron, is still an expensive device and only cost-effective when used with large numbers of patients. And with molecular medicine, timing is an issue. The fluorine molecule has a half-life of only 110 minutes, meaning every minute counts, Clark said. Right now, the only cyclotron available for medical work in Arizona is based in a Phoenix hospital. Alliance Imaging also serves Yuma and Tucson from Phoenix. "They can scan an average of six to eight patients per day," said Maureen Michinock, spokeswoman for Alliance Imaging. "Once the volume of patients builds up, we will schedule more days of service." She said Alliance has seen a need for PET scan service in Arizona. "We saw that the needs of patients for this type of service were not being met," she said. The hospital is concerned with scheduling. On days of service, every other Monday beginning Dec. 2, Alliance will bring up two shipments per day of the short-lived glucose potions. If patients are late for their appointments, that serving will no longer be effective because the fluorine isotope will have dissipated. The system is priced at about $2 million. At just five or six patients per week, the price for the hospital to run its own service would not be cost-effective. The spiked glucose alone costs $500 a shot. But with a mobile unit setting up shop in the hospital parking lot every two weeks, the affordability gap narrows, Brown said. Because a doctor's referral is required, PET scan imaging is covered by most insurance companies, Michinock said. Reporter Michael Marizco may be reached at [log in to unmask] or 556-2257. --- Outgoing mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com). Version: 6.0.408 / Virus Database: 230 - Release Date: 10/24/2002 ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn