CyberPET: a PET service distributed over a wide area

Aim: Demonstration of bi-directional PET data transmission, interactive display and co-registration, for the purpose of correlative imaging, treatment planning and teaching. Material and Method: In the year 2000, the initial problem to attend was to provide an effective PET service to a hospital (in Luxemburg) which lies 150 km away from a PET center (in another country). Once this solved, the procedure was expanded (in 2001) to co-registration with CT/MRI scans performed locally, and with radiotherapy simulation CT performed in another center 25 km away (in 2002). Equipment from various vendors was used (Siemens, Adac, GE, Hermes). With preliminary agreement of the national medical aid, patients are sent from the Nuclear Medicine Dept of the Centre Hospitalier in Luxemburg (CHL) to the Dept NM of the Saarland University Medical Center for PET examination. The digital data are then sent from the Siemens PET camera to a PC connected to the LAN, and then to a FTP server (Healthnet). The data are similarly collected by a PC of the hospital network in Luxemburg, and transferred to a Hermes NM station. The Dicom PET data are converted on the fly to Interfile, displayed interactively as any other tomographic data, printed and available on the NM image server. Since 2001, the PET data are co-registered with whole-body CT data recorded at CHL according to a specific protocol (see other paper of this group). Now in 2002, we are busy implementing the co-registration of PET data and simulation CT data obtained from the Centre Baclesse (CFB, 25 km from CHL) for the treatment planning of brain tumours (input into an ADAC system). Furthermore, we plan to send the data (after deletion of their digital ID) to a (South African) university which does not yet dispose of a PET camera, to allow the training of their registrars. Results: For the end-user clinician at CHL and CFB , the PET data have the quality of 'live data', which can be examined interactively, along with other imaging procedures and interpreted with the results of all other examinations, and thus better. The format conversion of data and their transmission over long distances saves the patient the replication of unnecessary examinations. Conclusion: The scheme proved successful. Beyond the technicalities, it needs a good understanding between people and institutions to be effective. It could also improve the efficiency of cyclotron-equipped PET centres serving smaller satellite hospitals