Technical Requirements of PET Systems for Assessing Gynecological Cancers

Abstract

The International Federation of Gynecology and Obstetrics has recognized the benefits of using Positron Emission Tomography (PET) imaging in the detection, stage evaluation and followup of gynecological cancers (GCs). However, conventional state-of-the-art PET scanners offer low sensitivity and non-uniform spatial resolutions which are insufficient for the correct diagnosis of onco-gynecological lesions. Extending the use of PET in the gynecological practice requires the development of patientadaptable scanners able to provide photon depth of interaction (DOI) information for 3D positioning of the events, time-of-flight (TOF) capabilities and high sensitivity. In addition, the equipment must achieve homogeneous spatial resolutions < 2mm in the entire field-of-view (FOV), better image contrast and, be affordable. The inclusion of such a dedicated PET equipment in gynecological oncology will impact the socio-sanitary field since better image quality enables for better diagnoses, which is a key factor in the recovery and life expectancy of patients. In this review, each of these points are studied, delving into the impact of PET imaging for GCs assessment and how may contribute improving diagnostic and therefore patient recuperation. The present article begins introducing GCs and its incidence in our society. This is followed by a description of the basic concepts underlying PET imaging, the historical facts that contribute to its development and, the main components typically encountered in PET detectors. Then, a revision of the state-of-the-art PET technology is provided highlighting the main limitations encountered for accurate diagnoses of onco-gynecological lesions and, the requirements to overcome them. Finally, some hints regarding the most suitable scanner design for the detection, assessment and followup of gynecologic oncology patients is offered.