Immediate Imaging InsightHow reviewing images from different modalities helps improve diagnosis

July 11, 2013 | Medical experts today often have access to images from a variety of modalities, such as positron emission tomography (PET), computed tomography (CT), or magnetic resonance imaging (MRI); great numbers of images from prior examinations; and visual data from other sources. When looking at a patient with a known malignant disease, for example, the prior images – possibly even from a different type of modality – might provide the decisive information for an accurate assessment of the disease status.


Text: Oliver Klaffke
Photos: Christian Kain


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On the way to the clinic.

A patient wants to know the reason for the pain in her back. As she was diagnosed with breast cancer a while back, she is anxious to find out whether the back pain has got anything to do with her cancer.

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Go to nuclear medicine.

Her doctors at Erlangen University Hospital in Germany decide to combine scintigraphy and CT to check whether the pain might be caused e.g. by bone metastases in the spine or by some kind of inflammation.

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Preparing for a scintigraphy.

For a scintigraphy, a radiopharmaceutical tracer is administered. The patient has to wait a while until it is evenly distributed in the body before the examination starts.

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The scintigraphy is done.

It shows regions of high metabolic activity. Together with the scintigraphy, a CT examination is performed. CT provides images of the bones.

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Fusing the CT and scintigraphy with syngo.via1.
Fusing the information from the two modalities is easy and efficient to handle and indicates the high metabolic activity and therefore the supposed source of the pain was not located within a vertebra but rather between two vertebrae. Radiologist Dr. Rolf Janka and his colleague Dr. Torsten Fritscher from nuclear medicine discuss the findings.


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The patient is relieved.

Dr. Janka tells her that it became clear that with a very high probability her pain was an orthopedic rather than an oncological problem. He hands her a CD with all her imaging data and the reports and wishes her well.


Oliver Klaffke is a science and business writer based in Switzerland and France. Among other publications, he has written for New Scientist and Nature in the past.