For any who may never need to read the results of a PET scan, such as a medical professional, patient, or loved one, here are mine from my very first ever. There is some sadness that I wasn't aware of yet, but there is a lot more happiness in it, and for that I am grateful.
PET - TUMOR IMAGING W/ CONCURRENT CT, SKULL BASE - MID THIGH: 1/25/2025
CLINICAL HISTORY: Rectal cancer initial staging. 58-year-old man with reported history of suspected
metastatic rectal cancer.
RADIOPHARMACEUTICAL: 13.5 mCi F-18 FDG was administered intravenously via injection. The
blood glucose level was 78 mg/dl.
TECHNIQUE: The F-18 FDG injection was followed by an uptake period of 55 minutes. CT was then
performed from the skull base through the mid thighs for attenuation correction, followed by positron
emission tomography (PET) imaging in the same distribution. PET images were viewed in axial, coronal, and
sagittal planes, along with reformatted CT images for anatomic correlation. Dose lowering techniques were
utilized which include adjusting the mA and/or kV to protocol and/or patient size.
COMPARISON: 12/23/2024 and 12/22/2024.
FINDINGS:
NECK:
Intracranial Structures: Visualized portions of the brain show normal metabolic activity. Brain parenchyma
is normal in appearance.
Paranasal Sinuses: Visualized sinuses are well aerated, with no air fluid levels or abnormal activity.
Mastoids: Mastoids are well aerated, with no air fluid levels or abnormal activity.
Orbits: The orbits, including intraocular and extraocular structures, are normal.
Salivary Glands: The salivary glands are symmetric, and have physiologic uptake.
Nasopharynx: Normal in appearance. Lymphoid tissues around the nasopharynx show normal uptake.
Oral Cavity and Oropharynx: Oral cavity and pharynx are normal in appearance. Lymphoid tissues around
the pharynges show normal uptake.
Hypopharynx and Larynx: Hypopharynx and larynx have normal physiologic uptake.
Trachea and Aerodigestive Tract: Normal.
Thyroid: The thyroid has normal parenchyma and normal physiologic uptake.
Other:
CHEST:
Lungs: 5 mm micronodule along the minor fissure which is below the resolution of PET. No evidence of
metabolically active lung lesion.
Pleura: No pleural effusion, pleural mass, or pneumothorax is noted. No abnormal FDG activity is seen in
the pleura.
Tracheobronchial Tree: Trachea and bronchi are clear.
Heart and Vasculature: The heart has normal metabolic activity. No evidence of pericardial effusion.
Thoracic vessels are normal in caliber.
Esophagus: Esophagus is normal, and has physiologic uptake.
Other:
Reference background activity (mediastinal blood pool): weight-normalized mean SUV is 1.5.
ABDOMEN AND PELVIS:
Liver: Metabolically active lesion in the lateral left hepatic lobe/segment III is consistent with a liver
metastasis measuring 3.3 cm with an SUV max of 8.0.
The gallbladder is normal. There are no radiopaque stones.
Pancreas: The pancreas is normal in appearance and has physiologic uptake, without mass or inflammatory
change.
Spleen: The spleen demonstrates physiologic activity without splenomegaly or mass.
Adrenal glands: The adrenals are normal, and have physiologic uptake.
Kidneys: Nonobstructing 4 mm calculus in lower pole of the left kidney.
Vasculature: There is diffuse calcific arteriosclerosis of the abdominal aorta without evidence of aneurysmal
dilatation.
Peritoneal Cavity: Normal. No mass or ascites are seen.
GI Tract: Metabolically active lesion at the rectosigmoid junction with an SUV max of 14.2 is consistent
with neoplasm. Additional foci of uptake in the mid to lower rectum with an SUV max of 15.8. Possibly
additional sites of disease are physiologic. Correlation with colonoscopy is recommended. Diverticula are
seen in the colon. No evidence of diverticulitis.
Reproductive Organs: There is enlargement of the prostate gland.
Urinary Bladder: The bladder is normal.
Other:
Reference background activity (liver): weight-normalized mean SUV is 1.8.
Lymph Nodes: Perirectal lymph node is enlarged with an SUV max of 4.1 and is concerning for a lymph
node metastasis measuring 18 x 15 mm.
Bones and Soft Tissues: Physiologic FDG uptake is seen in the bone marrow. There are no sclerotic or lytic
lesions.
*Degenerative changes of the spine.
PET/CT
IMPRESSION:
1. Metabolically active lesion at the rectosigmoid junction is consistent with biopsy-proven malignancy.
Additional foci of uptake in the mid to lower rectum may represent additional sites of disease or possibly
physiologic variance. Correlation with colonoscopy is recommended.
2. Metabolically active perirectal lymph node is concerning for lymph node metastasis.
3. Metabolically active liver lesion in the left hepatic lobe is consistent with a liver metastasis.
4. 5 mm micronodule along the minor fissure is below the resolution of PET. Imaging surveillance with CT
is recommended.
Here's to hoping this is the only one you'll ever read! If not, may the odds, as well as normality and normalcy, be ever in your favor!