vendredi 20 mars 2009

PET Scan

En français PET scan c'est TEP, Tomographie par Émission de Positron. L'acronyme anglais est Positron Emission Tomography. On ajoute le mot scan mais en réalité on n'a pas vraiment besoin. Tout ce qu'il ajoute c'est que les images sont obtenues par balayage en comparaison à une radiographie ordinaire qui est un cliché fixe.

Pourquoi je dois faire un PET , heu, un TEP? C'est que le chirurgien l'a demandé pour appuyer son analyse de mon dossier. La brochure que j'ai reçu à ce sujet peut aussi nous renseigner sur la raison de la demande du chirurgien.

Indications cliniques en Oncologie Colorectal:
  • Détection et localisation des récidives (élévation CEA) = pas mon cas
  • Staging des récidives = pas mon cas
  • Evaluation de la résectabilité des métastases hépatiques = fort probablement
  • Évaluation de la réponse locale et à distance au traitement = possible
Il y a plusieurs autres indications cliniques mais je ne vous ai exposé que la plus pertinente.

Cet examen demande une préparation particulière. Je dois être à jeun 6 heures avant l'heure de mon rendez-vous (dans mon cas cela signifie 1 heure du matin) seulement l'eau est permise pas de bonbon, pas de gomme, pas de pastille.

Je dois éviter les repas copieux la veille. De plus je dois éviter l'exposition au froid et l'exercice physique intense 2 jours avant mon rendez-vous.

Voici des informations du site du centre Paul Papin:

http://www.centrepaulpapin.fr/esp_visiteurs/informations_pratiques/consultations/medecine_nucleaire/tep.htm

Médecine Nucléaire
Scintigraphie
Tomographie par Emission de Positons (TEP)


Qu’est-ce qu’une tomographie par émission de positons ?

Au même titre que la scintigraphie (osseuse, cardiaque,... ), la TEP constitue une modalité d'imagerie fonctionnelle reposant sur l'administration au patient d'un traceur légèrement radioactif dont on étudie le métabolisme dans l'organisme. Dans le cas de la TEP, le traceur habituellement utilisé est un analogue du glucose marqué par le fluor 18, appelé le FDG.

La réalisation d'un examen TEP au FDG permet ainsi de visualiser la consommation cellulaire en glucose, dont on sait qu'elle est en général augmentée au niveau des cellules cancéreuses.

En fonction de la maladie cancéreuse considérée, l'examen TEP au FDG pourra alors diversement contribuer à la prise en charge du patient (diagnostic initial, bilan d'extension, choix du meilleur traitement, évaluation de la réponse au traitement,...).

Comment se déroule un examen TEP au FDG ?

Une perfusion intraveineuse est placée au niveau de l'avant-bras pour permettre l'injection du FDG.
Le patient reste ensuite au repos, allongé pendant une heure, pendant la phase de distribution du traceur dans l'organisme. Puis des images sont enregistrées par une caméra selon les mêmes principes que pour tout examen scintigraphique, pour une durée d'environ 20 à 30 minutes.

Combien de temps dure l'examen ?

Au total, il faut compter environ 3 à 6 heures de présence dans le service (accueil, mise en place de la perfusion, injection du FDG, fixation du traceur, acquisition des images). Environ une heure est passée couché dans la machine.

L'examen est-il douloureux ?

Le patient ne sent que la piqûre de l'aiguille lors de la mise en place de la perfusion.

L'examen est-il dangereux ?

Le produit injecté (FDG) n'est pas toxique et ne provoque pas de réaction allergique.La quantité de rayonnement reçu est faible, du même ordre de grandeur que celle reçue lors de la réalisation d'une radiographie du thorax.




Alors dimanche matin pensez à moi et à Marie-Josée qui m'accompagnera. Nous serons à L'Hotel-Dieu armé de notre patience.

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Also, Tim said he hid the Sports section in the event I could to discover the time with the gang.
Boy was I surprised while you and many types of my guys were to the sidewalk outside Sylvia's (but not Sarabeth's)!
Rrt had been an enjoyable gospel brunch and surprise. Hee!

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