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Puzzling scan results

Puzzling scan results

Posted By
lkb
10/10/2019 11:10pm
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lkb
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Replies: 5

Hello MelPeeps! Today I got the results from my latest PETCT and MRI scans. Will probably hear from my doc Monday, but in the meantime:
MRI: Abnormal right level 2B lymph node measuring 10 mm, likely representing nodal metastatic disease
PETCT: - Right level 2B/3 node: Resolved. Previously 4 mm with SUV max 5.3.
Not sure how a tumor can be both resolved and bigger, unless it means dead tissue.

Anyone had an experience like this/have an idea?

Current treatment is Pembro plus IL-12 injections followed by electroporation. The 2B lesion has been there since December 2018.

With thanks,
Lisa

October 2017 primary scalp WLE; SLNB; partial neck dissection (PND). July 2018 recurrence in neck. August 2018 second PND. September 2018 started Nivo. December 2018 SRS for brain met January 2019 Pisces trial IL-12 + Pembro. .

 

Linny - (10/11/2019 - 7:09am)

Wow, that's a head-scratcher for sure. It does sound like the MRI may have picked up on some dead tissue. Let's hope that's all it is.

Stage IIIB, Unknown Primary; 1 positive node in left axilla. Diagnosed December 2010.

CynthiaLee - (10/11/2019 - 1:15pm)

Previously 4mm with SUV max 5.3 ....this is what was seen prior to this scan. This scan it is resolved. The SUV max isn't a size determination.
The maximum standardized uptake value (SUVmax) is widely used for measuring the uptake of FDG by malignant tissue (Gambhir 2002). Increased FDG uptake values reflect the viability of cancer cells, and can be imaged and quantified using PET.
So previous scan showed 5.3 uptake in 4 mm area. That now shows as resolved.

CynthiaLee - (10/11/2019 - 1:17pm)

Sorry, I see size now in lines abive and can't delete

Bubbles - (10/11/2019 - 6:00pm)

Hey Lisa,
Absence of activity (lighting up on the PET) is more important that the size noted on the MRI. So you may well be dealing with "increased size" on the MRI due to an increase in necrotic tissue that it can "seen" there...but that is dead....and therefore NOT lighting up on the PET! So that's probably a good thing. If it is a superficial node, a biopsy could give a definitive answer....or you and your doc may be comfortable with watching and waiting. Just my thoughts. I'm sure your doc will give a full explanation. Fingers crossed that you will hear good news!! celeste

lkb - (10/11/2019 - 6:04pm)

Thank you, Celeste!

October 2017 primary scalp WLE; SLNB; partial neck dissection (PND). July 2018 recurrence in neck. August 2018 second PND. September 2018 started Nivo. December 2018 SRS for brain met January 2019 Pisces trial IL-12 + Pembro. .