PET Readout

Results

PET/CT scan

BISHOP, VICKI Exam Date: 06/29/2020 

PET - TUMOR IMAGING W/ CONCURRENT CT, SKULL BASE - MID THIGH: 6/29/2020 SKULL BASE TO MID THIGH PET/CT - CLINICAL HISTORY: Left breast carcinoma subsequent treatment strategy 

COMPARISON: PET/CT 05/01/2020, PET/CT 02/13/2020 FINDINGS: NECK: Visualized portions of the brain show normal metabolic activity. Brain parenchyma is normal in appearance. The orbits, intra and extraocular structures are normal. Visualized sinuses are well aerated, with no air fluid levels or abnormal activity. The salivary glands are symmetric, and have physiologic uptake. Oral cavity and pharynx are normal in appearance. Lymphoid tissues around the pharynges show normal uptake. Larynx is normal, and has physiologic uptake. The thyroid has normal parenchyma and normal physiologic uptake. CHEST: Scarring in the upper lobes bilaterally is stable. Ill-defined airspace opacity in the left upper lobe/lingula is again identified measuring 1.5 x 2.5 cm, previously 0.9 x 1.4 cm. Maximum SUV is 4.3, previously 1.5. No new pulmonary lesions. No pleural effusion, pleural mass, or pneumothorax is noted. No abnormal FDG activity is seen in the pleura. Esophagus is normal, and has physiologic uptake. The heart has normal metabolic activity. No evidence of pericardial effusion. Reference background activity (mediastinal blood pool): mean SUV is 2.0. ABDOMEN AND PELVIS: Previously measured hepatic lobe lesion 2.4 x 2.5 cm, previously 2.0 x 1.9 cm. Maximum SUV 15.4, previously 10.9. Lateral left hepatic lobe segment lesion, new maximum SUV 7.5. The pancreas is normal in appearance and has physiologic uptake, without mass or inflammatory change. The spleen demonstrates physiologic activity without splenomegaly or mass. The adrenals are normal, and have physiologic uptake. Physiologic FDG excretion is seen in the kidneys. No contour deforming masses, calculi, or hydronephrosis. Normal physiologic activity is seen in the bowel. No evidence of bowel obstruction. The reproductive organs are normal in appearance and activity. The bladder is normal. Reference background activity (liver): mean SUV is 2.8. LYMPH NODES: New lymphadenopathy * Anterior mediastinal lymph node 1.4 x 0.9 cm, maximum SUV 5.3 * Aortopulmonary window lymph node 1.1 x 1.3 cm, maximum SUV 4.9 * Right subpectoral lymph node 0.7 x 1.1 cm, maximum SUV 10.6 Prior lymphadenopathy * Left submandibular lymph node maximum SUV 10.2, previously 8.0 * Left supraclavicular lymphadenopathy maximum SUV 8.1, previously 6.6 * Porta hepatis node maximum SUV 29.8, previously 9.9 * Precaval lymph node maximum SUV 14.0, previously 4.5 BONES AND SURROUNDING SOFT TISSUES: Physiologic FDG uptake is seen in the bone marrow. There are no sclerotic or lytic lesions. PET/CT IMPRESSION: 1. Disease progression with new lymphadenopathy. 2. Previously characterized lymphadenopathy has progressed as well. 3. Progression of intrahepatic disease with enlarging lesion and new disease in the left hepatic lobe. 4. Ill-defined pulmonary opacity in the left upper lobe has enlarged and is more metabolically active. Findings are suspicious for neoplastic involvement in this clinical setting.

So .... what does this all mean? 😕

Yellow = Chest (new)

Blue = Liver

Green = Lymph Nodes

Pink = Overall Findings

Basically, what I've said in the previous post. Liver is growing; a second lesion on the liver, approximately one centimeter. Possible lung involvement in the chest (note: we've seen this; comes and goes. Could mean infection - I am on a ZPack now). New lymph node involvement.

In a word? Okay, a couple of words …. Cancer Sucks!! Not good results but could be worse. Let's hope the new chemo kicks some booty!!