PET/CT

(Positron emission tomography and computed tomography)

As of June 30, 2025

Dr. Jonas Müller-Hübenthal founded the Praxis im KölnTriangle in 2005, to introduce new imaging methods, in particular the PET/CT method (positron emission tomography and computed tomography) in Cologne. PET/CT displays metabolic information on an anatomical map with an accuracy that was previously not possible and was used for the first time in Zurich in 2000, and in Essen in 2001. In order to regularly combine PET/CT examinations with the MRI method (magnetic resonance imaging / magnetic resonance tomography), our consultant specialists must have mastery of both the specialist disciplines of radiology, and of nuclear medicine. Since 2006, we have carried out over 14,000 PET/CT examinations with our experienced team of consultant specialists and radiographers. We carry out these examinations for outpatients as well as inpatients, on behalf of various hospitals in the area.
PET/CT has established itself as the central imaging tool for oncological diagnostics: the metabolic data from the PET scan are clearly presented on an anatomical map created by a CT scan, taken at the same time.

The images created using PET/CT can be used for presenting and diagnosing a variety of cases:

oncological diseases including lung cancer, prostate cancer, breast cancer, malignant melanoma, lymphoma, head, neck and brain tumors, rectal cancer, pancreatic cancer,

non-oncological diseases, including the search for the origin of inflamatory diseases,
neurological issues (e.g. Alzheimer’s disease, Parkinson’s disease),
Cardiological issues (heart involvement in sarcoidosis, heart valve inflammation, myocarditis, coronary heart disease, pacemaker infection),
rheumatoid diseases,

orthopaedic issues such as loosening of prostheses.

Indication

Most PET/CT examinations are carried out for initial staging, or recurrence staging, of cancer. PET/CT is an excellent tool, particularly when there is a suspicion of recurrence. In those cases we aim to identify diseased loci when they are still at an early, limited stage, at which point curative therapy avenues may still be available. This is particularly valuable given that previously incurable metastatic stages of the disease, if they only affect individual locations, can now be successfully operated on and/or irradiated.

PET/CT is also used for tumor search, interim staging, final staging and therapy monitoring. (See quality assurance report PET/CT and MRT-PET of the MCC Practice in the KölnTriangle – [PDF]) ).

Depending on the type of disease the indication for PET/CT are outlined in national and international guidelines. In individualised treatment paths, PET/CT is often used at the start of therapy, as well as for monitoring the success of therapy.

Influencing treatment decision

In our Quality Assurance Report, we were able to prove the accuracy of the diagnoses made in our practice, but also the influence that the PET/CT examination had on therapy strategy. In more than 30% of our examined cases, therapy was adapted according to the results of the PET/CT imaging. A correct diagnosis is the basis for a successful therapy.

Change in the extent of therapy: PET/CT data changed the ‘dosage’; the surgical area was adjusted; chemotherapy was intensified or lessened.
Change in therapy strategy: An originally planned therapy (e.g. surgery) was replaced or augmented by another strategy (e.g. chemotherapy or radiation).

Change in the therapeutic approach: an originally planned curative therapeutic approach could no longer be pursued, for example due to a newly discovered metastasis. However, there are also converse cases in which suspicion of metastasis, based on external preliminary examinations, is weakened or refuted, and the patient can be returned to the path of curative intervention.

Device

Our PET/CT device is from Siemens (Biograph mCT 128) with CardioGating specifications Since 2013 we have been recognized by EARL as an “accredited PET/CT center of excellence”. This accreditation is checked quarterly by quality checks on our ¹⁸F PET/CT.

Centres of Excellence Network

Tracer / Radio-Pharmaceutical Agent

Depending on the medical query, different tracers are used, visualzing receptor density or metabolic activity (figuratively speaking, colour them and make the disease visible). The required radiopharmaceutical agent is ordered for each patient / examination individually, from the cyclotron where it is produced. The production process and delivery is complex and needs to function perfectly for each individual scan: We place an order, the tracer agent is then produced to order in the clean-room laboratory, couriered to us (depending on the tracer, it may come from Bonn, Berlin, Bad Oeynhausen, Nijmegen Holland, Lille France), prepared for injection by our team, and finally administered intravenously to the patient. It is a highly complex process for a substance that has a very short half-life: between one and two hours, depending on the tracer. The patient’s arrival at the practice, admission at reception, preliminary consultation before the examination, application of the tracer, then the examination procedure itself – all must be adapted to the physical properties of the tracer. Punctuality, and processes that are as accurate as possible, are of greatest importance for the quality of an examination. If the examination time window is exceeded for whatever reason, the tracer has decayed and an examination is no longer possible. The Ga68 tracer has a half-life of 68 minutes, for the F18 it is 110 minutes.
In the Praxis im KölnTriangle, all tracers based on Ga68 and F18 have drug approval in Germany, and are therefore approved for use on humans.

^F18-FDG fluorodeoxyglucose) is the ‘workhorse’ of PET/CT scans. It has a very wide range of applications, and is used as standard primarily in oncological cases. In addition, it is used for cardio-PET/CT, for neurological cases (dementia and Parkinson’s diseases) and for the search for unclear bacterial sources of inflammation, or for the question of loosening of prostheses.

^F18-PSMA is the tracer for prostate cancer diagnosing relapse after therapy, if PSA-levels rise again, but also for initial staging in high-risk situations.^F18-PSMA has drug approval; ^Ga68-PSMA, which does not have a drug approval, is not used in our practice.)
^F18-Dopa is used for Parkinson’s disease and endocrine-active neuroendocrine tumor examinations.
^F18-Florbetaben (Neuraceq^®) amyloid is used in dementia or cardiac amyloidosis cases.
^Ga68-is used for neuroendocrine tumor scans.
^F18-fluoroethylcholine or fluoromethylcholine) was formerly used for prostate cancer scans; it is now used for parathyroid adenoma examinations.

Availability of tracers varies. ^F18-FDG can usually be ordered from one working day to the next. The order must be placed by 12 noon. ^F18-PSMA tracers are available to us on Tuesdays and Thursdays. Here the lead time is usually one week. Some tracers have a lead time of several weeks.

Process of the Examination

Due to the complex examination process (including ordering and providing the individually required tracer, as described above), the Praxis im KölnTriangle works exclusively according to an ‘ordering system’: Appointments for the PET/CT examination are agreed in writing with each patient. Depending on the examination protocol, we ask patients to plan 3-6 hours for the examination, including a preliminary interview and a possible presentation of the examination results.

Registration and preliminary discussion
Tracer injection and rest period: After injecting the tracer into a vein, patients usually rest for about 60 minutes so that the substance can spread throughout the body. For the quality of the examination, it is important that patients are dressed sufficiently warmly and do not feel cold. (This also applies to the day before the examination.)
Image acquisition: The actual PET/CT image takes between 15-30 minutes, depending on the area being examined. In some cases we need additional recordings at a slightly later time. The examination is painless. Patients are examined lying flat on their back. The examination table moves slowly through the scanner. The tube is large (78cm diameter), and well ventilated. The examination is almost silent. Patients can speak to the radiographer who is carrying out the examination at any time via an intercom.
After the images have been taken, patients can leave the practice.
A report of the findings and the examination documentation are created and sent to the referring doctor within a few working days following the examination.

We ask patients to send us all relevant existing medical findings in advance of their examination (e.g., external MRI, CT and PET/CT images – on a CD/DVD or cloud based link / QR code, to our KölnTriangle practice). We also ask for relevant written reports, surgery reports, doctor’s letters from the oncologist/other pre-treating doctors, tumor-board-reports, pathology reports) in order to fully prepare the appointment. Before an appointment date is agreed with the patient, the practice team checks whether, based on these preliminary findings, an examination is justified, and if so, determines which type of tracer will be required. We also need the creatinine and TSH basal values to carry out the examination. For more detailed information on the examinations with the different tracers, please refer to our information sheets:

Information about the ^F18-FDG examination
Information about the ^F18-PSMA examination
Information about cardio PET/CT
Information about ^F18-F-Dopa and ^F18-Florbetaben (Neuraceq®) amyloid examination

Examination documentation

The measurements and standardized reports of the diagnostic process are printed out, saved onto DICOM CD/DVD and summarized in a folder. This is then sent to the respective referring doctor or clinic.

Reimbursement of costs

As a rule, private insurance companies in Germany cover the costs of PET/CT, if this examination method corresponds to the treatment guidelines for the clinical issue at hand. The cost for a whole body PET/CT scan ranges between EUR 2200 and EUR 4000 depending on the tracer to be used, additional imaging of body parts i.e. head, heart, thorax, abdomen, pelvis region, additional diagnostic CT, supplementary standardized reports..

Availability of appointments

Depending on the availability of the tracers, we can offer an appointment for the PET/CT examination within 3-5 working days.

In particularly urgent cases, we can scjedule ^F18-FDG-PET/CT examinations the next working day. This requires a written appointment to be made by 12 noon the day before.

We can generally schedule ^F18-PSMA examinations 1 week in advance ; in urgent cases it is usually possible to offer an appointment for the next examination day (Tuesday and Thursday).
Andere Tracer in this case, the availability of the tracer determines how quickly we can offer an appointment.

Quality Assurance Report

We have collated all medical outcomes of the Praxis im KölnTriangle (covering the past almost 20 years of PET/CT experience), in our Quality Assurance Report. We created the first of these overview reports in April 2020 The updated report is scheduled for Q3 2026. The report is in German.

Report – As of April 2021 – [PDF]

Report – As of November 2026

Links

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Adresse

MVZ
Praxis im KölnTriangle
Ottoplatz 1
50679 Köln

Öffnungszeiten

Mo – Fr 8.00h – 18.00h
und nach Vereinbarung

Anfahrt

Öffentlicher Nahverkehr
Parkplätze in der Nähe

Kontakt

Allgemein 0221 88 84 80 – 0
MRT 0221 88 84 80 – 63
PET/CT 0221 88 84 80 – 61
CT 0221 88 84 80 – 62
Schilddrüse 0221 88 84 80 – 64
Privatpraxis 0221 88 84 80 – 66

Zertifikat Zusatzqualifikation Prostata-Diagnostik

Zertifikat Zusatzqualifikation Künstliche Intelligenz

FOCUS Siegel 2026 Dr. Jonas Müller-Hübenthal Radiologe