Avalanche photodiodes now and possible developments

Avalanche Photodiodes (APDs) are now out of their infancy and are used in large numbers in the electromagnetic calorimeter of CMS where they have to stand the extremely hostile environment of LHC. This type - with smaller sensitive area and arranged in monolithic arrays - is an excellent candidate for the read out of scintillating crystals in medical imaging and a PET scanner operates already successfully since more than 3 years. We present the properties of the device used in CMS and possible improvements of the structure, which could open the door for new applications. Operating APDs at low temperatures or in Geiger mode will allow single photon counting and in future they could replace photomultiplier tubes.