Quarter Century Clinical PET/Computed Tomography: Transforming Medical Oncology Practice

It is nearly 100 years since basic scientific research led to advances in PET and over a quarter century since the US Centers for Medicare and Medicaid Services (CMS) approved reimbursement for PET for clinical investigation of pulmonary nodule. A prototype hybrid PET/computed tomographic (CT) scanner was developed, and clinical evaluation commenced in 1998. Hybrid PET/CT scanners were introduced to the clinical practice in 2001 and more recently the hybrid PET/MRI scanners. Evolution of PET in clinical use and in medical oncology has been an iterative process of incorporating tremendous advances in technology, radiochemistry, and validation and application through clinical trials and practice. Technology advancements allowed PET spatial resolution to improve more than a factor of 10 and sensitivity by a factor more than 40, compared with the early designs of scanners to the current modern PET/CT scanners, including whole-body PET/CT scanners. PET/MRI allows combining of the high sensitivity of PET and high soft tissue resolution and functional components of MRI.