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PET Scan Results - Stage 4 - How does this look?

PET Scan Results - Stage 4 - How does this look?

Posted By
nasullivan
10/4/2019 8:58am
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Replies: 8

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
dependent/atelectatic changes.

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.
KIDNEYS/URETERS/

BLADDER: Excreted activity present.
Unchanged bilateral renal cortical cysts.

ABDOMINOPELVIC NODES: No abnormal uptake.

BOWEL/PERITONEUM/
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
spine.

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
benign.

Focal uptake in the right forearm likely at the site of radiotracer
injection.
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
adrenal metastases.
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.

I'm not a doctor, but that all certainly looks like very good news to me. It looks like most everything bad is shrinking and dying. Notice that many of the regions of uptake are now down to the same level of uptake as the reference regions in the liver, which hopefully means there is no more cancer living in those areas. Looks like something is working for you. Best wishes.

Thank you!!! I appreciate :)

Yep! Like Doragsda just said, your now current Uptakes seem lower then its comparison from your last scan! Like Doragsda admitted, im no doc, i too have to investigate each meaning when i read my own reports along with a Nutshell description from my onco (is my meds working or not!) Sure looks promising though!! Yaay! Are you diagnosed with Colitis?

Melanoma Will Not Beat Me or my MRF Family!
www.wespark.org
www.covvha.net

Thank you, Mike! This my grandmothers' recent PET Scan. She was Stage 0 in 2o15. They cut it out (original tumor was 0.2 mm). They never did a scan on diagnosis or on follow-up (which she went every 3 months). And now, in July was diangosed stage 4 - on a fluke brain MRI.

This is all so crazy. Do you know if PET scans are typically done on stage 0 melanoma? She is 82 - but has no other health problems. Thank you for being an inspiration!

I don't believe any scans are usually done at Stage 0, as it is considered very low risk for recurrence. I don't think the standard protocols call for scans and I doubt that insurance would pay for them. My wife was 2c with a deep and ulcerated melanoma on her leg in December 2016. A PET was done and was clear, but a PET is not a great tool for imaging the brain. 6 months later I took her to the ER as she couldn't walk and a MRI found two brain mets. I suspect they were there in December, but a MRI is not a standard at 2c either so usually isn't done.

Hi naSullivan, i think a stage 0 is basicly a watch and wait, of course with a possible biopsy to confirm disease, however, standard of care can be overridden amongst all the insurance plans out there (what will be paid for/honored) because different doctors & oncologist or derm docs have their own way of approaching diseases so, i do know once your at a stage of 3a, b, c to 4 most tests are utilized (biopsys, MRI, PET & CT scans) anything under 3 goes over my head, but i do know docs will go to bat for you to run tests its just up to your insurer...

Melanoma Will Not Beat Me or my MRF Family!
www.wespark.org
www.covvha.net

Unchanged probably reactive heterogeneous bone marrow uptake with few
slightly more prominent foci without CT correlate, indeterminate

What does that mean? She is now having hip pain.....does it seem suspicious?

Your grandmother’s PET scan looks good to me. Her hip pain reminds me of my experience. I had pain in a rib, before a PET scan and biopsy showed melanoma in that rib. Walking became very painful, before a PET scan showed melanoma in several of my bones.