Pet Scan Result

I'll consult with the oncologist next week and share the summary. But for those who want to know, here are the results of the PET scan. For reference, my C6 vertebrae was the site of my 2005 cancer:

Study Result

Narrative

NUCLEAR MEDICINE F-18 FDG PET-CT SCAN, SKULL TO THIGHS, INITIAL dated 3/24/2021
2:42 PM.

CLINICAL DATA: New left lung mass and pleural effusion. Primary malignant
neoplasm of oropharynx (HCC) [C10.9 (ICD-10-CM)].

COMPARISON STUDY: Contrast-enhanced CT of the chest, abdomen and pelvis March
12, 2021.

DOSE: 12.4 mCi F-18 FDG IV via a left antecubital fossa intravenous access
site.
Serum glucose level: 86 mg/dL.

TECHNIQUE: Approximately 1 hour following F-18 FDG tracer injection, F-18 FDG
PET images were acquired from the base of the skull through the proximal thighs.
Noncontrast low-dose CT imaging skull base and neck, chest, abdomen, pelvis and
proximal thighs was acquired and used for F-18 FDG PET attenuation correction
and for anatomic correlation, but is not of diagnostic image quality.

FINDINGS:
F-18 FDG PET Imaging: Reference data includes a volume of right hepatic lobe
parenchyma which contains maximum SUVs of 3.7 and mean SUVs of 2.6. Superior
vena cava mediastinal blood pool SUVs are up to 2.3.

The large left lower lobe mass measures about 7.2 x 9.2 cm (image 114, series
3). It is very hypermetabolic though it contains central zones of relative
photopenia, hypometabolism or reduced vascularity. It contains SUVs up to 12.1.

The fairly large left pleural effusion is not hypermetabolic, the left pleural
space generally containing SUVs less than 0.6. There is low-grade glucose
metabolism in the medial left lower lobe atelectatic appearing parenchyma such
as seen lateral to the descending thoracic aortic course.

Previously noted small, up to 0.7 cm diameter, left anterior juxtadiaphragmatic,
epicardial fat region lymph nodes (images 137 and 138, series 3) are not
identifiably hypermetabolic. This area contains SUVs up to 1.1.

There is marginal glucose hypermetabolism in the region of the left pulmonary
hilus, with SUVs at the anterior left hilar level up to 3.0.

No metabolically active mediastinal or right hilar lymph node sites are
identified.

There is reduced F-18 FDG uptake in the mid to upper cervical spine bone marrow
at and cephalad to the C6 level.

Other sites of F-18 FDG tracer uptake between the skull base and thighs are
explainable by expected physiologic processes.

Other low-dose anatomic correlation CT imaging findings:

Noisy low-dose images of the inferior portions of the brain show no evidence of
focal mass or mass effect upon the midline intracranial markers.

There are right neck surgical clips and postsurgical scarring. No metabolically
active enlarged cervical lymph nodes are identified.

The large left pleural effusion, left lower lobe mass and left lower lobe
atelectatic appearances are similar to that seen on previous CT imaging. There
is respiratory motion obscuration of the lung bases. Previously noted small
inferior right lung zone pulmonary nodules (not well seen owing to respiratory
variation and blurring) are not metabolically detectable by F-18 FDG PET imaging
There is again some rightward displacement of the chest and heart. The ascending
aorta caliber of 4.0 cm is within normal limits.

Other low-dose anatomic correlation CT imaging findings in the chest, abdomen
and pelvis are similar to that better demonstrated by the recent diagnostic
technique contrast-enhanced CT imaging study.

There is no evidence of a soft tissue mass in either proximal thigh.

IMPRESSION:

1. Large left lower lobe mass is hypermetabolic with irregular central zones of
photopenia, presumed necrosis.

2. Large left pleural effusion is not noticeably hypermetabolic. The small left
juxta diaphragmatic lymph nodes are not identifiably hypermetabolic.

3. Borderline left hilar region F-18 FDG tracer uptake.

4. Cervical spine reduced bone marrow metabolic activity, query previous
radiation therapy

5. Evidence of fairly extensive previous right neck surgery.

Verified by Henry Vea, M.D. on 3/24/2021 3:28 PM in PowerScribe 360