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Showing results for tags 'pet scan'.
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PET scan day. Another day, entering the unknown. The weather was awful, so we left for Bismarck early. My desire to get these exams over and done outweighed my impatience at sitting in hospital and clinic chairs for hours at a time, staring at the walls, watching solemn faces entering and exiting. Although arriving early to appointments, we never had to wait long to enter the inner sanctum of the hospital, those closed doors to the great unknown led by people much younger than myself who always want to know your name and birthdate. About five minutes from the hospital parking lot, the radiology tech called to make sure we would make the appointment. Snow was falling, and it was blustery, but not impossible, to navigate the streets. The problem was the snow in the driveway leading to the county road and then the county road connecting to Highway 1806. It took some time and man power to clear a path from the garage to the road. County plows had miles and miles to clear, and many times it was late afternoon when they reached our neck of the woods. This winter had started early and was relentless, with snow piling up around around our yard and the wind sculpting a most beautiful prison wall around the house. Our house has three exits. Thie first challenge of the day this winter was finding a door that the wind hadn’t packed full of snow overnight. But heck yea, we will be there. I’m not going to miss this appointment. But, with this wild winter — storms and snow, and travel warnings nearly every week, there were more than a few moments of panic as our path to the hospital began shrinking with every passing weather alert. It’s North Dakota. We have lived here all our lives, and cold, windy, snowy days don’t always mean you can’t get around in town. But living in a semi-secluded place without a farm tractor to move those drifts became an issue. The weather was much better Thursday than Wednesday when we went for the biopsy. I could NOT miss either of these tests. “Absolutely, we will be there in about five minutes,” I said. “We will be there 30 minutes early for the appointment.” It paid off to arrive early. After a very short wait, a young man in a mask, named Max, called my name. No one really explained the PET scan. Maybe I wasn’t listening, I found some notes about not eating or drinking six hours before the test. I knew I had to have an injection and wait for the solution to make its way through my body, followed by the scan. It would probably be two and one-half hours at best. I longingly looked at the water fountain over my shoulder as I said goodbye to my husband and followed the young man down a long dimly-lit green hallway. It was cold. Really cold. We entered a room, or sort of a room with an industrial lift. You know, a platform with a railing like construction workers would use to paint a ceiling. “What’s this?” “Can’t have you guys walking up the stairs now, can we?” Max said. He all but strapped us in with safety harnesses, and up we went. It was a smooth ride. As we rode the lift a mere four feet to a bank of computers, another man in a mask turned his chair around but didn’t say a word. I had no idea if he was smiling or not. That’s the trouble with masks. To the left was what looked like an airport jet bridge. You know, like an airplane connected to the walkway connected to the terminal. It was even colder in this room, if you could call it that. At the end of the jet bridge, an empty scanner like the ones for the CT scan took up a substantial area in a dark room. I found out later that it wasn’t a room but a semi truck trailer in disguise. It looked more like a space ship. Max guided me to the right to another very industrial-looking room. Once I settled in one of two chairs separated by a divider, he drew some blood, checked my sugar and put an IV in the vein in the crook of my arm. He carefully put on a new pair of rubber gloves and lifted a canister from a heavy metal cooler in front of yet another couple of computers with ever moving screens and blinking lights. The room has an eerie atmosphere under the fluorescent lights and bare walls. The radioactive symbols, the lights, cold and darkness were reminiscent of the 50s sci-fi movies I watched on the old movie channels. Remember, I love Star Trek. Most websites will tell you you receive only a small amount of radioactive sugar called fluorodeoxyalucose-18, FGD-18 for short, it sure seemed like a lot more in my head. Thank goodness once the radioactive glucose was injected, the IV was removed. I hate those things. I’m sure I commented more than once on the chill in the room. Max grabbed a heated blanket, helped me spread it over my legs, and drew the curtain. He said he would return in 45 minutes. UGH. The chair reclined but not enough to be comfortable. I was cold and not prepared for the starkness of the room. The computer was the only light I could see. The numbers went up and down with no rhyme or reason. I tried to close my eyes and relax. Thank goodness I didn’t notice the clock on the computer until at least 15 minutes had passed. I waited with my eyes closed, hoping the time would pass quicker. Max came back, but not for me. It was only then I realized someone was waiting behind the curtain hiding that second chair next to me. If the scan lasted 30 or 40 minutes, that meant at least 30 minutes till my turn in the scanner. This experience has been a lesson in patience for sure. After more time had passed, Max returned and asked if I wanted to use the bathroom before the scan. I said sure, at my age not wanting to miss an opportunity to pee. Rather than go out past the waiting room where my husband was reading, we went down another hall, a locked elevator, a couple of wrong turns and a restroom with that same circle in yellow and maybe red. You know, the radioactive warning symbol. I don't recall right now. PET, or Positron Emission Tomography, is a nuclear imaging technology. According to a Stanford Medical website, “Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material to diagnose or treat a variety of diseases, including many types of cancers, heart disease, and certain other abnormalities within the body.” Thinking about radioactive materials, on the way back to the scanner I said, “Might I glow in the dark?” Max said, “Sorry, no.” Oh well, I tried. Obediently, I followed him across the jet bridge into the space ship, then into the scanner and out again. It was painless. The platform moved ever so slowing from the top of my head to my knees pausing at intervals to complete a scan section, or at least that’s what I assumed. They said I did good, meaning I didn’t wriggle around. I got up and we went down the lift and out the key-coded door to the waiting room. Much to my surprise and joy, another friend, Diane, had taken the time out of her day, made her way across the snowy Missouri Interstate 94 bridge and kept my husband company during this unknown ordeal. There she was, and I was overwhelmed with gratitude. It meant a lot to me that she showed up and agreed to go to lunch with us before she was off to donate blood. I had been craving pancakes for days.
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Almost every lung cancer survivor has a positron emission tomography (PET) scan these days. Now, a PET is often given with a computerized axial tomography (CT) scan. The diagnostician is a radiologist; a discipline that does not write in lingua franca. What do the report words mean? Here is a summary of my August PET-CT to interpret radiology speak. INDICATION: (Why am I getting this scan) “The patient…with non-small cell lung cancer of the right main bronchus diagnosed in 2003 status post pneumonectomy….He has undergone previous surgery for bronchopleural fistula repair…Chemotherapy last administered May 2006…Cyberknife therapy for recurrent disease in March 2007…He more recently has cough and chest discomfort.” That’s me, no doubt, but this summary is important. Radiologists see many scans and sometimes results are misreported. TECHNIQUE: (Test scope and method) Note details about the accuracy of the CT. “These images do not constitute a diagnostic-quality CT….” The CT results help to precisely map or locate the PET results but cannot generate a diagnostic grade image. COMPARISON: (Other scans reviewed while looking at this one). “Report only (no image reviewed) from PET-CT 3/8/2013. CT of chest and abdomen 8/22/17 (looked at image).” A CT scan is normally performed first. PETs follow and accuracy is enhanced if the radiologist has access to prior images. To improve access, have all your scans done at the same medical facility. FINDINGS: (The result) “…showed no convincing PET evidence of FDG-avid (fluorodeoxyglucose — radioactive tagged glucose seeking) recurrent or metastatic disease.” This is what we want to see in the first sentence. Then, the radiologist peels back the onion with detail. “There is mild heterogeneous hypermetabolism (diverse increased rate of metabolic activity)…with a few small superimposed foci (above the hypermetabolic area that is of particular interest)…more intense activity showing a maximum SUV of 3.5 (SUV — standardized uptake value)….When compared to [past reports] uptake…showed SUVs ranging from 2.6 to 2.9. This is strongly favored to be inflammatory.” Relief —this is my chronic pain site caused by 3 thoracic surgeries in the same location! “A somewhat retractile appearing mass (drawn back into lung tissue)…in the left upper lobe is stable in size…This shows minimal uptake…and is most compatible with the site of treated tumor.” My CyeberKnife-fried tumor scar. I do love precision radiation! What are concern ranges for SUV uptake? First, consider what is measured — cellular metabolic rate; more simply is demand for glucose, the fuel of metabolism. Cells with high metabolism ingest more tagged glucose. The PET shows differences in consumption (uptake). SUVs below 2.0 are normal. SUVs above 2.0 are suspect but between 2.0 and 4.0, uptake could be from injury or inflammation. Readings above 4.0 tend to be cancer but there can be other explanations. Higher than 4.0 is likely cancer, especially when paired with a CT find. Cancer demands glucose to fuel mitosis or growth by cellular division. Get and keep copies of all your diagnostic imaging. Keep track of the findings. I use a spreadsheet to record date, location and indications. Dr. Google is a great source for medical definitions. The best possible outcome for any scan is NED (no evidence of disease). May NED be with you. Stay the course.
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- diagnosing lung cancer
- pet scan
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"Count-off...One, Two...Count-off...Three, Four...Bring it on down now...One, Two, Three, Four, One-Two...Three-Four!" My life is filled with counting. As a young soldier on the march, we counted cadence to stay in step. The rhythm of the cadence was an elixir to the mile-upon-mile-upon-mile of forced march in full combat load. They always scheduled the forced march on the hottest day, or the wettest day, or the coldest day of the year. One memorable march was the day after a hurricane! Weather or not, we marched and counted. After diagnosis with lung cancer, my life embraced a different sort of cadence. There was the countdown to scan day, then time stopped waiting for results. One...what time is it...just ten in the morning...the clock battery is out...is it back...how bad...how many nodules...how big...ten-oh-two...mets in the bones...liver also...scan tech didn't smile...he saw something...ohGod.... Life just stopped waiting for results. Time stopped! Waiting for scan results is absolute misery coupled with measured doses of agony and anguish, torment, despondency and gloom thrown in for good measure! Each day was a twenty-five-mile forced march that started but never ended. Cancer sucks but waiting for scan results sucks squared! Stay the course.
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- scanziety
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Hi all, I am writing because there is a lot of confusion in my family right now. My father is 80 years old and is a two time cancer survivor - in 2004, he was diagnosed with stage 2B colorectal cancer, he had the tumor removed and chose not to have chemo or radiation. In 2007, was diagnosed with stage 2B prostate cancer, they removed his prostate and did not have further treatment. He is very health, works out every day, active, social, eats healthy, non-smoker but unfortunately, his family is plagued with a history of cancer. This winter, he began coughing a lot and has wheezing when breathing. He finally asked the doctor for a chest x-ray where they "found something." He was then referred to get a CT scan, which revealed a 1.8cm nodular opacity in the right middle lobe of his lung. I also want to note that in 2011 (when doctors released him from follow up care to monitor a recurrence from his previous cancer), the nodule was 0.4cm in size. We have been put on the wait list for a PET scan but, in the meantime, we don't know what to think. I also want to add that the current CT scan says that along the nodule, shows an air bronchogram. We don't know if this is a good or bad thing. If anyone can shed some light while we wait for further testing, it would be greatly appreciated. I heard there was a testing calculator to measure the likelihood of this nodule being cancerous in the time it has grown but cannot seem to find it. I am doing a lot of research but, again, if anyone has some suggestions or insight, it would be more than helpful. I pray for everyone in this forum as I, too, have had to face ovarian cancer. Thank you in advance for your time.
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Good evening to all. My name is Katie and I live in Western North Carolina. I am guilty of having lurked around this forum, partly because I was so blasted angry with a diagnosis of lung cancer. You see, I am a 2-yr breast cancer survivor, and I can assure you that apart from the obvious difference, BC and NSCLC are worlds apart. Some family background. In 1972 at the age of 45, my mother died from metastatic melanoma. I am the eldest of five and to date only my surviving sister has escaped a cancer diagnosis. Our youngest sister was diagnosed with an aggressive breast cancer at the age of 44, and she died just before her 50th birthday. The youngest of the family, my brother Val died from esophageal/gastric cancer within two months of diagnosis. My surviving brother is a melanoma survivor. At the risk of sounding pedantic, we take cancer very seriously in my family. (Our dad had heart disease) My breast cancer was IDC, but it had not gone beyond the breast and unlike my sister's, it was not HER/2+. Christine was diagnosed in 2005 and no one talked about the BRCA variants back then, at least not around here. My tumor was tested, and apart from having some unknown variants it was presumed unlikely to return. In January of this year, a X-Ray indicated either an infection or nodule in my left lung. After a course of antibiotics did not resolve my coughing I had a CT which indicated an "irregularly shaped mixed-density lesion measuring 26x11x15mm", as well as a nodule in the right lung that measured 11x11mm. The first concern of course was that it was metastases from the breast, so the first biopsy was taken from the larger tumor in the left lung which was stained to rule out BC, and diagnosed as NSCLC Adenocarcinoma.. My tumors present as "ground-glass opacities", a feature of which I am told means that there's a high probability of me developing more, so preservation of lung function is a priority. The smaller tumor in the right lung was also biopsied, and it's presumed to be identical in nature to that in the left. I've seen recent postings about biopsies not being done or even necessary when a lung tumor is smaller than 1cm, and I am not understanding that logic. As for the PET scan, I had one after the initial biopsy, and here you have it: Low-level FDG accumulation in the region of the previously biopsied irregular left upper lobe nodule (SUVmax 2.31) is less than the blood pool activity. No significant focal FDG accumulation is identified elsewhere in either lung. And here is the Impression: The irregular, biopsy-proven malignancy in the left upper lobe has low-level FDG accumulation. No FDG-avid adenopathy or FDG-avid extrathoracic metastases are identified, but given the relatively low FDG avidity of the primary lesion, this examination may be less sensitive for detection of metastatic disease. Additionally, the other known mixed density and ground glass lung nodules may not be well characterized by PET due to their morphology. Follow-up CT scans are recommended. PET scans are not infallible! Had biopsies not be done, my cancer might not have even been found. And do you know what was said to me at the first Lung Cancer Conference which took place after the PET? The good news is that you don't have cancer anywhere else in your body! Which is simply untrue as none of the docs can tell that from my PET. Undoubtedly other PET results are clearer than mine, but if I hadn't turned to Dr. Google, I would have been blissfully (and in my opinion, ignorantly) unaware. My treatment to date has been stereotactic radiation (Cyberknife) to each lung, which involved fiducial marker placement around each tumor, which was incredibly hard on both lungs. I don't know the grade or staging of my cancer because to completely remove the tumors would mean removal of those parts of the lungs, and the docs want to preserve my lungs' capacities. I understand the reasoning, but it feels like I'm in limbo, just waiting for the follow-up CT next month to see how the tumors responded to the radiation. My onco sent me to a thoracic oncologist at Duke who told me that the next step will be testing genetic testing of the biopsies; if they have any of the variants that can be targeted with less potent versions of the chemo or immunotherapies designed to treat Stage IV mets. Also, such testing could help us know if the tumor in the right spread from the left, or if they're both primaries. I'm pretty much done, thanks for those who've hung in with me here. I will close by writing that I've made the decision to not undergo any more radiation treatments, altho I will take chemo, etc. This may sound radical and crazy but I've been researching medical cannabis treatment of cancer, and I believe that it's a viable option for me, legality aside. Happy Fourth to all! .
