Indications:

I.  Oncologic:

LUNG

• Characterization of a noncalcified solitary pulmonary nodule (SPN):  diagnosis of cancer has not been established
• Initial staging for lung cancer 
• Diagnosis, staging and re-staging for gastrointestinal lung cancer

GASTROINTESTINAL

• Diagnosis, staging and re-staging for cancer of the esophagus
• Diagnosis, staging and re-staging for colorectal cancer
• Determination of the localization of tumor for colorectal cancer when there are elevated blood levels of C.E.A. marker

LYMPHOMA

• Diagnosis, staging and re-staging for lymphoma
• Staging and re-staging for lymphoma when it is used as an alternative to gallium scan.  Gallium scan for evaluation of lymphoma patients is no longer performed now for several years in the U.S. and Europe. 
• Early assessment of therapy response (after 2-3 cycles of chemotherapy)

MELANOMA

• Diagnosis, staging and re-staging for melanoma
• Evaluation of recurrence of melanoma prior to surgery, as an altermative to the gallium scan

BREAST

• Additional study to other imaging modalities for staging of breast cancer with distant metastases, or for re-staging of breast cancer with locoregional or metastasic recurrence 
• Additional study to imaging modalities to monitor the response of breast cancer to treatment in patients with locally advanced disease and metastasis, when a change in therapy is foreseen
• Early assessment of therapy response (after 1-2 cycles of chemotherapy)

HEAD AND NECK

• Diagnosis, staging and re-stating for head and neck tumors, excluding brain and thyroid
• Re-staging of thyroid cancer of a recurrent follicular or residual type, previously treated with surgery and ablation with radioactive iodine, with a thyroglobulin level greater than 10ng/ml and a negative I-131 full body scan
• Search for occult primary neck cancer with a biopsy proven metastatic neck lymph node.

II.  Neurologic:

• Refractory seizures, pre-surgical evaluation
• Frontotemporal dementia differentiation from Alzheimers and other forms of dementia such as that associated with Lewy-Body disease. 

III.  Cardiac:

• Establish viability of the myocardium when a cardiac S.P.E.C.T. is negative
• Establish viability of the myocardium as an initial diagnosis or after an inconclusive S.P.E.C.T., before making the decision to revascularize the myocardium

Private health plans usually approve additional applications following consultation with trained personnel in the office of the PET-CT service provider to ensure proper utilizacion of this hybrid imaging modality.