PET-CT is often advertised as “a single examination that examines the entire body and detects the earliest tumors”. In China, PET-CT is the gold sign of many high-end medical check-ups, and in recent years the overseas medical check-up market has become increasingly hot, with Japan as the representative, PET-CT is even a gimmick of high class medical check-ups. In fact, there have been many controversies and questions about PET-CT examination, “I am worried about cancer, can I have a PET-CT?” “PET-CT is so expensive, is it necessary to do it?” “I heard that PET-CT is very effective in checking tumors, but there is radiation, so I am really torn whether to do it or not.” Radiation is a scary word among common people. People want to enjoy the high technology of PET-CT, but they are also afraid of the health hazards caused by radiation. How should we choose, see what experts say. PET-CT Status quo: PET-CT has become a gimmick for high-end overseas medical checkups “I saw a group of overseas medical checkups plus tours, and the propaganda gave a good feeling, saying that the PET-CT examination technology in Japan is world leading, and local people are using this examination to prevent cancer, so I want to enroll my dad and mom in a group”, Ms. Chen is a filial daughter, and she She told the reporter that she was worried about her parents’ health because of their advanced age, so she heard from her friends about this kind of overseas medical checkup, which is not bad. In the past few years, as the public attaches importance to health, some travel agencies have launched medical health tour groups to Japan and South Korea, etc., while traveling for medical checkups, of which an important item is PET-CT examination. Japan was the first and most widely used country for PET-CT medical checkups, giving rise to the international “medical checkup tourism” service. The emergence of PET-CT has been called “another revolution in medical imaging” and has been recognized and widely paid attention to by the medical community as “the crown of modern medical technology”. In China, the cost of PET-CT examination is not low, and it is self-paying without medical insurance, but it is very hot, and it is easy to search on the internet to find the publicity of various hospitals’ related medical examination programs. It is understood that the cost of PET-CT examination in China is not yet unified, basically the cost of PET-CT examination varies from region to region and from hospital to hospital, at present only the cost of PET-CT examination in Shanghai is unified, the whole body examination is 7000 RMB and the local examination is 4000 RMB; the cost of PET-CT examination in Beijing is between 9000-13000 RMB for the whole body and between The cost of PET-CT in Beijing is between 9000-13000 RMB for the whole body and 6000-10000 RMB for the local area. Guangzhou is probably between the two cities, with whole-body and partial exams ranging from 7,000-10,000 RMB. The cost of operating PET-CT is quite high, with an import price of tens of millions of RMB, and the cost of personnel and maintenance fees is also a significant expense. So the cost of opening a machine is quite expensive for the people. Controversy: Is it necessary to pay tens of thousands of dollars for the examination at every turn? PET-CT can be said to be the world’s most high-end medical imaging diagnostic equipment, which combines the two technologies of positron emission tomography and X-ray tomography and has been used in clinical practice for more than 10 years. Professor Cheng Muhua, Director of Department of Nuclear Medicine, The Third Hospital of Sun Yat-sen University, introduced that the biggest advantage of PET-CT lies in the initial screening diagnosis and treatment evaluation of tumors. Specifically, it includes: early diagnosis and differential diagnosis of tumor, identification of tumor stage and recurrence, guidance of tumor treatment plan, evaluation of tumor prognosis, etc. Currently, it is recognized that PET-CT has more than 90% of diagnostic accuracy for cancer. Meanwhile, PET-CT also plays an active role in the diagnosis and evaluation of neuropsychiatric diseases and cardiovascular diseases, such as Parkinson’s disease and Alzheimer’s disease. Compared with blood sampling for tumor markers, CT and MRI examinations, PET-CT is more accurate and comprehensive in judging treatment effects. For example, imaging examinations such as CT and MRI have been able to better detect the size, shape, location, and relationship with surrounding structures of lesions. They play an important role in tumor diagnosis. However, in some cases, these examinations cannot well identify benign and malignant lesions. If PET-CT examination is done to detect the metabolic activity of lesions on the basis of CT imaging, the diagnosis can be well made. Experts: ordinary people are not suitable for use as health check PET-CT applied to health check is an abuse. A few years ago, Dr. Lin Hongwei, an oncology surgeon at the 306th Hospital of the People’s Liberation Army, took the lead in publicly questioning the use of PET-CT for health checkups on microblogs, saying that it is misleading to recommend PET-CT as a medical checkup to society. Jiang Ningyi, director of the Department of Nuclear Medicine at Sun Yat-sen Memorial Hospital of Sun Yat-sen University and chairman of the Nuclear Medicine Branch of Guangdong Medical Association, agreed with Lin Hongwei’s statement. He believes that clinical screening of tumors must be evaluated by oncology specialists based on the patient’s age, occupation, lifestyle habits, family history and other factors. High-risk groups can be considered for further identification through PET-CT when they are highly suspected of tumors clinically and at the same time when conditions allow. Apart from the price and risk of PET-CT, the fact is that PET-CT cannot detect all tumors. According to Lin Hongwei, PET-CT is mostly used to confirm and locate late stage tumor recurrence, or diagnose tumors of unknown origin, but nowadays it is used as a “cash cow” by some institutions. In fact, according to the statistics of the General Hospital of the Chinese People’s Liberation Army (301 Hospital), the proportion of PET-CT detecting malignant tumors in healthy people is only 1.3% in terms of the effectiveness of cancer screening. Regarding the scope of PET-CT adaptation, the relevant departments of the former Ministry of Health had responded that experts generally recommend that PET-CT is not suitable as a general medical checkup. The 2011-2015 National Positron Emission Tomography Scanner Configuration Plan requires: “strict medical institution configuration standards, strengthen access management, regulate the use, and protect the legitimate rights and interests of patients. positive PET-CT examination rate of not less than 70%.” This statement means that PET-CT must be used symptomatically. So, as Professor Qiao Youlin, Director of the Epidemiology Research Department of the Cancer Hospital of the Chinese Academy of Medical Sciences, pointed out, there are mature, easy and inexpensive detection methods for many cancers, while PET-CT examinations are too expensive and risky “to have the value of promoting to the whole population.” Reminder: PET-CT is not suitable for everyone By risk, Prof. Qiao Youlin means “radiation”. Radiation is a scary word among the general public, who want to enjoy the high technology of PET-CT, but are also afraid of the health hazards of radiation. An article in the April 2009 issue of Radiological Medicine points out that radiation dose studies conducted in Hong Kong and the United States have shown that whole-body PET-CT scans are currently associated with significant radiation doses and cancer risks. “There is no denying that PETCT has radiation and poses potential risks, otherwise the health department would not require PET-CT to be banned for general medical checkups,” Cheng Muhua said. Cheng Muhua introduced, PET-CT radiation dose source from radionuclide and X-CT two parts, which, radionuclide radiation for 4.6-6.2 mSv, due to technological advances, the latest injection drug can make the radiation dose down to about 3.9 mSv; the second part of the radiation dose of the main source of CT scan, but the CT used in PET-CT than the conventional CT dose With the modernization of PET-CT, the radiation dose of a whole body examination is reduced from about 15 mSv to about 7.5 mSv. Currently, the state has not yet set an upper limit for the amount of radiation a patient can receive during a medical examination, but there is a standard for medical personnel, which means that it should not exceed 20 mSv per year. From this it can be deduced that patients receiving a single PET-CT examination receive radiation that is well within the safe range and that this radiation is still transient. However, some experts suggest that not all hospitals are as strong as the large tertiary hospitals in the north, Shanghai and Guangzhou, and not all PET-CTs available in China belong to the newer and more advanced equipment, so if we add up the amount of radiation from both radionuclide and CT, the amount of radiation received from a whole body PET-CT is at least 20 mSv. In any case, in Hongwei Lin’s opinion, PET-CT examinations require a drug to be injected into the body, which has radiation. It is impossible to be completely harmless. Japan is one of the few countries where PET-CT is widely used for medical examinations, which has given rise to international “medical tourism” services. This service is currently attracting a large number of Chinese people to Japan for this purpose. However, various information shows that even in Japan, there are controversies about PET-CT checkups. Kohta Katano, director of the Statistical Analysis Department at the National Cancer Center, told the Chinese media that there is insufficient evidence on the cost-benefit of PET-CT screening. “Currently PET-CT physical examinations are mainly driven by the interests of some medical institutions, and we are still waiting for more evidence and will not promote it as a guideline.” Conclusion: Weighing the pros and cons to choose “weighing the pros and cons” is a word that both Cheng Muhua and Jiang Ningyi repeatedly mention. the opportunity to save lives. Of course, “PET-CT, like other medical examinations and treatments, can be used to treat diseases, but it can also have certain side effects, which should be weighed against the pros and cons; and surgery can be effective in treating diseases, but it can also bring about certain structural or functional damage to tissues and organs. Therefore, any medical act should be done to benefit the patient, that is, to find the best node in the cost-benefit, to strictly grasp the indications for PET-CT examinations, and to use PET-CT examinations using the principles of justification and optimization, so that the benefits received by the examinees clearly outweigh the risks.” Cheng Muhua said. PET-CT is the perfect integration of PET and CT, with PET providing detailed molecular information on the function and metabolism of the lesion and CT providing precise anatomical positioning of the lesion, which can obtain tomographic images of the whole body in all directions in one image. The emergence of PET-CT is another revolution in medical imaging and has been widely recognized by the medical community as the “crown of modern medical technology”. PET-CT is a perfect integration of the functions of the most advanced PET scanner and advanced spiral CT equipment, which is mainly used for early detection and diagnosis of major diseases in the fields of tumor, brain and heart.