[cgrundy]

Interpreting PET/CT scan results

by cgrundy on Sat Apr 26, 2014 10:47 am

Any thoughts on these PET/CT scan results would greatly be appreciated.

I'm particularly interested in understanding the results that start with "Chest: There are scattered hypermetabolic pulmonary nodules", but comments and/or help with interpreting the other findings also would be appreciated.

EXAM: PET/CT Diagnosis; Lymphoma=W, 04/22/2014 03:44 PM

CLINICAL INDICATIONS: Hx. Myeloma. BM negative with worsening blood counts. Evaluate for plasmacytoma with worsening back pain.; Multiple myeloma, without mention of having achieved remission(203.00), ,

COMPARISON: No prior studies available for comparison.

CT DOSE:
DLP: 936 mGy x cm
kVp:

FINDINGS:

Head/Neck: There is evidence of marked muscular activity within the head and neck region, likely physiologic. Physiologic FDG uptake is noted in the salivary glands and tonsillar tissue. There is no hypermetabolic cervical or supraclavicular lymphadenopathy. Normal, intense physiologic uptake is noted in the cerebral cortex gray matter and subcortical nuclei without gross hypermetabolic abnormality.

Chest: There are scattered hypermetabolic pulmonary nodules and nodular consolidations involving the right lung with maximal SUV of 6.3 involving the right upper lobe. There is no hypermetabolic axillary, mediastinal, or hilar lymphadenopathy. Physiologic FDG uptake is seen in the myocardium.

Abdomen/Pelvis: Physiologic FDG uptake is seen throughout the spleen and bowel. There is heterogeneous FDG activity throughout the liver. Physiologic FDG excretion is seen in the kidneys, ureters, and bladder. There are no hypermetabolic lesions in the adrenal glands. There is no hypermetabolic inguinal, retroperitoneal, paraaortic or portocaval lymphadenopathy.

Musculoskeletal: There are multiple foci of increased FDG activity involving the thoracic spine with maximal SUV of 13.3, sternum with maximum SUV of 7.9, left femur with maximal SUV of 53.3 and right scapula with maximal SUV of 7.6 concerning for neoplastic involvement. No focal hypermetabolic osseous lesions are identified.

Impression
IMPRESSION:

1. Multifocal hypermetabolic activity involving the thoracic spine, sternum, left femur and right scapula concerning for neoplastic involvement is identified.

2. Right lung hypermetabolic nodular consolidations might represent infectious/inflammatory or neoplastic process. Attention followup is recommended.

3. Heterogeneous FDG activity throughout the liver with no definite evidence of discrete hypermetabolic lesion, attention on followup is recommended.

[Dr. Adam Cohen]

Re: Interpreting PET/CT scan results

by Dr. Adam Cohen on Sun Apr 27, 2014 9:12 am

With the given history of myeloma, the findings in the bones would be consistent with active myeloma bone lesions. The findings in the lung are non-specific, and could represent myeloma or other tumor (which would be highly unlikely), current or recent infection (e.g. pneumonia), or other inflammation in the lung.

Interpretation of scans should always be done in the context of the patient's history and clinical signs and symptoms, so your doctor is the best person to interpret these results and make recommendations about the next steps.

[cgrundy]

Re: Interpreting PET/CT scan results

by cgrundy on Sun Apr 27, 2014 1:46 pm

Thank you Dr. Cohen!

Is the SUV of 53.3 in the femur unusually large? Or could it be something else?