Have you ever read a report from a PET scan or a CT scan? Those things that give people with cancer what’s known as “scanxiety?” I am sharing here the narrative sent to me and my oncologist for discussion. This was the one that led to the decision to radiate my vertebrae when the radiologist found the new (now demolished) tumor on my lumbar 4. Enjoy. I will leave you with the exact document I have to translate on my own prior to my appointment.
Narrative clinical history female metastatic breast cancer. 55 years old. This PET sequence for comparison view and evaluate responses to therapy.
Tracer information into the right mediport. Not the wrong mediport. They take from me in safety they give to me in danger for I am scanned from my head to my toes. Relieve me of the seas of yellow fluid yet my livers not included
Scan algorithms based on a phantom, clear sinuses, no lymph nodes.
Paranasal sinuses: Clear
Thyroid: Not well visualized.
Lymph nodes: No FDG-avid or enlarged supraclavicular, mediastinal, hilar, or axillary adenopathy.
Lungs: Scarring in the posterior right upper lobe. No FDG-avid pulmonary lesions. Lung parenchymal evaluation, including for punctate nodules, is limited by low dose CT and non-breathhold technique.
Pleura: Unchanged pleural-based nodule along the periphery of the left lower lobe between the sixth and seventh ribs with minimal uptake above background measuring 1.5 cm with SUV max of 2.6.
Chest Wall: No FDG-avid lesion. Unchanged dense soft tissue within the bilateral breasts without significant focal uptake.
Heart: Atherosclerotic calcification of the coronary arteries is present. No pericardial effusion.
Other Findings: None.
Liver: No FDG-avid liver lesion.
Spleen: Normal in size and metabolic activity.
Pancreas: No FDG-avid lesion.
Adrenals: No FDG-avid lesion.
Bowel: Physiologic FDG uptake is seen in the bowel. No focally FDG-avid lesion.
Kidneys/Bladder: Normal physiologic excretion of the radiopharmaceutical. No FDG-avid lesions.
Lymph Nodes: No FDG-avid or enlarged abdominal, retroperitoneal or pelvic adenopathy.
Vasculature: Normal abdominal aortic diameter (<3cm).
Other Findings: Diffuse peritoneal thickening is similar in appearance to prior CT, with unchanged more focal nodularity along the right lower pelvis which is additionally unchanged in CT appearance with mild associated uptake with SUV max of 2.4 (212). The latter is newly apparent from more remote PET. Increasing now moderate volume ascites.
Bones: New focus of uptake within the L4 vertebral body with unchanged underlying sclerotic focus with SUV max measuring 4.8 (172). Unchanged sclerotic appearance of the axial skeleton and ribs, and patchy sclerotic appearance of the proximal appendicular skeleton compatible with diffuse treated osseous metastases. Mild asymmetric linear intercostal uptake along the posterior right chest wall (135) without convincing underlying CT correlate, overall non-specific, but with attention recommended on follow-up.
Other Findings: None.
1. New moderate focal uptake within the L4 vertebral body concerning for progression of osseous involvement from PET/CT 4/12/2019. Diffuse sclerotic osseous lesions are otherwise not hypermetabolic.
2. Increasing now moderate volume ascites with persistent peritoneal thickening and regions of peritoneal nodularity with mild uptake, remain concerning for malignant involvement. Evaluation on PET is limited due to variable physiologic bowel uptake
I have personally reviewed the images for this examination and agree
with the report transcribed above.