e-Anatomy

PET-CT images provided by G. Chuto - MD

This module is devoted to the anatomy of the human body as studied when performing a PET scan with FDG injection.
It contains 280 images in axial section, ranging from cranial base to the root of the thighs, with over 250 anatomical structures captioned, with 4 selectable image types (PET, scanner, or PET-CT)
It is particularly aimed at doctors and nuclear medical technicians, radiologists and oncologists, including the disease spread assessment of cancers.

PET-scanner images with FDG

The PET-CT images, which pertain to a healthy male subject, were provided by Dr. William Chuto. There are four types of images, typically composed of a positron emission tomography combined with a scanner:

• PET-CT fusion: combining image scanner data and FDG tracer scintigraphy. These images are often very educational but are not used routinely.

PET-CT : anatomy of the neck, thorax, abdomen and pelvis

• CT (abdomen-mediastinum): whole body scanner images without injection with window function permitting the study of the soft tissues, including lymph node structures, mediastinum and abdomen.
• CT (lung-bone): stronger window function, allowing a better visualisation of the pulmonary parenchyma and the lungs.
• PET: tomographic images with attenuation factor correction, allowing the visualisation of areas fixing the tracer (e.g. heart, brain, urinary tract).

Positron emission tomography: Pelvis , Urinary bladder

Anatomical structures captioned on a PET-CT

250 anatomical structures of the neck and trunk have been captioned, using only the structures visible and studied through praxis on a PET scanner:

• The general anatomy presents the principle regions of human body, useful in locating a tumoral process: axilla, quadrants of the abdomen ... etc.
• The bone (skeletal system) presents the different bones of the neck, trunk and root of the lower limbs fairly approximately to avoid overloading the module.
• The articular system presents the large joints of the human body, with particular focus on the spine.
• The muscles (muscular system) have been exhaustively annotated, apart from the erector spinae muscles and certain muscles of the pelvic floor that are not identifiable on this scanner.

Positron emission Tomography - Computed tomography: IASLC - Lymph node stations

• The respiratory system includes the main structures from the nasal cavity to the bronchi.
• The bronchopulmonary segments have been identified by captioned areas with the help of the classification of the Terminologia Anatomica (numbers vary depending on the source areas, e.g. Boyden).

Positron emission tomography with Computed Tomography (PET-CT): Bronchopulmonary segments

• The thoracic cavity contains the large mediastinal regions and the cardiac structures.
• The digestive system includes the oral cavity, pharynx, oesophagus, stomach, large and small intestines, liver and pancreas. We have here included the spleen, which, however, is a lymphoid and not digestive organ.
• The hepatic segmentation represents the 7 segments of the liver by means of zones and legends.

PET-CT fusion images: Hepatic segmentation , Peritoneal Cancer Index

• The abdominal cavity includes the different spaces (peritoneal, retroperitoneal, retropubic) and mesenteries (mesentery, mesocolon).
• The Peritoneal Cancer Index is presented in the form of zones numbered 1 through 12 of the different possible locations of peritoneal carcinomatosis. A diagram of this index is available in the classifications tab. This index is still not officially recognised but is widely used in clinical practice.
• The urinary system is comprised chiefly of the kidneys and bladder.
• The male reproductive system was captioned so simply in order to be able to quickly locate structures such as the seminal vesicles or the prostate.
• The endocrine glands include the thyroid, the thymus (illustrated despite its atrophying into adulthood) and the adrenal glands.
• The arteries have been cursorily captioned, primarily as they form basic anatomical landmarks.
• The veins include the upper and lower vena cava system as well as the portal system.
• The lymph nodes tab describes the lymph nodes as described in the Terminologia Anatomica – names often not used in current practice.
• The ganglionic areas pick up the classifications used in oncology and surgery (cervical and thoracic lymph nodes (IASLC)) in the form of differently coloured regions.
• The nervous system is not easy to study on CT scan without injection.

The Details tab

This will allow all the structures to be displayed, or only those images having a low level of detail.

Language and anatomical terminology

We have used the Terminologia Anatomica to caption for all the anatomical structures, with translations into English, French, Japanese, German, Chinese, Portuguese, Russian, Czech and Spanish.