REFERENCE REGIONS: SUVmax and mean in a reference region in the liver
are 3.1 and 2.7, previously 2.8 and 2.4.
SKULL/SCALP: No new abnormal uptake. Unchanged mild
uptake in pituitary with no companion CT correlate, probably physiologic.
HEAD/FACE: Resolution of FDG avidity in the
multifocal hyperattenuating brain metastases.
NECK: No abnormal uptake.
LUNGS/AIRWAYS: Markedly decreased FDG uptake and size of
right upper lobe paramediastinal pulmonary nodule, 1.5 x 0.9 cm,
previously 2.1 x 1.7 cm, SUV 2.7, previously 17.8. Again noted scattered
non-FDG avid subcentimeter bilateral pulmonary nodules, mostly unchanged
with the exception of right upper lobe anterior, 0.5 x 0.4 cm, previously
0.7 x 0.6 cm, current series 3, image 152. Mild bibasilar probable
PLEURA/PERICARDIUM: No abnormal uptake.
MEDIASTINUM/THORACIC NODES: Decreased FDG uptake and size (difficult to
measure on noncontrast companion CT) of right mediastinal and hilar nodes:
* Right upper hilar, SUV 2.7, previously 9.3, current series 3, image 131.
* Right hilar, SUV 3.5, previously 7.7, current series 3, image 135.
HEPATOBILIARY: Pattern of diffuse mild heterogeneous
uptake in the liver probably related to statistical noise with no definite
suspicious focal uptake in the liver. Post cholecystectomy.
SPLEEN: No abnormal uptake.
PANCREAS: No abnormal uptake.
ADRENAL GLANDS: Decreased uptake and size of left adrenal
metastasis, 1.0 x 0.9 cm, previously 1.3 x 1.2 cm, SUV 3.6, previously
8.5, current series 3, image 182.
BLADDER: Excreted activity present.
Unchanged bilateral renal cortical cysts.
ABDOMINOPELVIC NODES: No abnormal uptake.
MESENTERY: Slightly more prominent diffuse
increased FDG uptake in the colon.
PELVIC ORGANS: No abnormal uptake.
BONES/SOFT TISSUES/EXTREMITIES: Unchanged heterogenous marrow
uptake with again slightly more prominent focal areas without CT
correlate, for example representative left sacrum, SUV 4.2, previously
3.2, current series 1200, image 249. Unchanged degenerative changes in the
Post Right hip replacement arthroplasty. Unchanged mild heterogeneous
uptake at the shoulders and knees probably degenerative/inflammatory. Mild
diffuse uptake in muscles of the forearms and lower extremities considered
Focal uptake in the right forearm likely at the site of radiotracer
Decreased FDG uptake and size of left cutaneous/subcutaneous soft tissue
thickening in the left foot, SUV 2.2, previously 5.2.
OTHER FINDINGS: None.
IMPRESSION: Since August 2, 2019
1. Resolution of FDG uptake in the multiple brain metastases.
2. Markedly decreased size of pulmonary, mediastinal nodal, and left
3. Decreased uptake in left foot cutaneous/subcutaneous soft tissue
thickening, probably resolving cellulitis.
4. Unchanged probably reactive heterogeneous bone marrow uptake with few
slightly more prominent foci without CT correlate, indeterminate.
5. More prominent diffuse increased colonic FDG uptake, probably
inflammatory immune mediated colitis. Recommend clinical correlation.