It was on 1st July 2009 when the first patient in Bulgaria was examined with the so-called PET scanner or Positron Emission Tomography at the Nuclear Medicine Clinic at UMHAT "St. Marina", thus making it a pioneer in this field in our country. At that time the procedure had become a standard diagnostic test at the leading medical centres in Europe and around the world. For instance, more than 2 million procedures have been performed in the USA each year. The team of medical doctors, physicists and nurses has gained valuable clinical experience over these ten years, and the examination has been performed for more than 20 000 patients across the country.
"Positron Emission Tomography - Computed Tomography (PET/CT) Scanning is based on state-of-the-art technology that helps us to diagnose cancer clusters so that an immediate therapy plan for the patients can be drawn up. We have saved plenty of human lives over the ten years thanks to the high precision of the examination that locates the disease and shows its dissemination in the human body," explained Assist. Prof. Borislav Chaushev from the Nuclear Medicine Clinic at UMHAT "St. Marina".
"The largest percentage of the tests was performed in patients with different types of tumours - lung cancer, colorectal cancer, breast, skin, bone, or digestive system cancer, haematological diseases, and other oncological diseases. However, the equipment is also used in neurology - in Alzheimer's disease, Parkinson's disease, or in search of an epileptic outbreak. Since we are the only hospital with a PET/CT scanner in Eastern Bulgaria, we admit patients from Varna, Burgas, Dobrich, Silistra, Dobrich, Shumen, Targovishte, Razgrad, Ruse, Veliko Tarnovo, Gabrovo. There are many patients coming from all over the country, even from quite remote settlements," added Assist. Prof. Chaushev.
Assoc. Prof. Chaushev shared reminiscences on how, in the very beginning, doctors and patients had been waiting for the landing of the plane, transporting the radiopharmaceutical (contrast medium) needed for the tests. While, at present, for more than 5 years the hospital "St. Marina" has had its own cyclotron complex, where it is produced.
Assoc. Prof. Chaushev explained the main aspects of this important diagnostic procedure that usually makes cancer patients quite anxious.
What is PET scanning?
PET or Positron Emission Tomography is nuclear medicine imaging procedures, performed by medics to determine certain diseases. On the one hand, PET scanning allows physicians to detect whether there is a disease, and on the other hand, they can use the information for planning the therapy, monitoring the patient's condition and the efficacy of the therapy.
What is PET scanning used for?
PET scanning is used as a medical method to show existing or potential problems at the cellular level. This helps physicians to determine and diagnose complex systemic diseases such as cancer and brain diseases.
This is feasible because during the examination, doctors use rapidly degrading radioactive markers that get into the organs and tissues, and there is a high level of metabolic activity in some diseases. For example, a large amount of the substance is accumulated in the cancer cells, and consequently they are brightly lit on the screen. Thus, doctors can use the examination to determine the early-onset of a cancer, its metastases, to trace its aggression, and control the efficacy of the disease treatment.
What is the procedure like?
PET scanning at UMHAT "St. Marina" is performed within a day. Prior to the examination, the patient receives a contrast agent (radiopharmaceutical) that is accumulated in the body for about an hour. The time may vary, depending on which part of the body is to be tested. The scanning procedure lasts between 30 and 40 minutes.
After completing the procedure, the patient can go home or continue with his/her daily routine. Doctors recommend drinking greater amount of water to get the marker used out the body more quickly.
The procedure is painless. Despite the fact that the contrast medium is a radioactive marker, the radiation exposure for the patient is extremely low. People who are allergic to iodine, aspartame or saccharin have to notify the doctors in advance. The examination shall not be performed on pregnant women, while nursing mothers are recommended not to breast feed their infants for 24 hours after the test.
PET-CT examination is performed a minimum of 30 days after chemotherapy, at least 4-6 weeks after surgical interventions, and 12 weeks after radiotherapy.
What types of documents are required for making an appointment?
PET/CT scanning is free of charge. The patient is required to submit certain documents in order to make an appointment - 8A Form (medical indication for performing procedures, issued by a specialist physician), Form №119 (green sheet) or an outpatient treatment record (ambulatory sheet), issued by a specialist, where the diagnosis and indications for performing PET/CT scanning are noted down, epicrises of a surgical treatment performed, chemotherapy, radiotherapy, tumour markers related to the oncological disease, and diagnostic imaging, provided there are any - CT, MRT, ultrasound examination of abdominal organs, etc.
The specialists directing patients for PET/CT scanning are usually oncologists, radiotherapists, abdomen, breast and neurosurgeons, and specialist - internal diseases - gastroenterologists, pulmonologists, hematologists, urologists, pediatricians, cardiologists and neurologists.