How to Interpret Pet Scan

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How to Interpret Pet Scan

by Teddyr on Wed Nov 01, 2006 12:00 AM

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Earlier this month, I had a chest x-ray as part of a routine annual physical. The x-ray indicated a nodule. Next move was a CT scan which confirmed the nodule and gave its size - 1.6 cm, but radiologist could not confirm whether it was benign, so I had a PET scan. PET indicated the nodule, and the radiologist thought it was benign, but couldn't state so unequivocally.I was advised to have another CT in 3 mos. to ensure that the the nodule was stable and had not grown. The SUV on the PET was 2.1, mildly hypermetabolic. Does anyone out there know how to read the SUV scale. What is high? What is low? The websites are bewidlering. Also, do you think it would better to just go ahead and have a needle biopsy and not wait for another CT?? Thanks for your help. teddyr

Thoughts

by Amnia on Wed Nov 01, 2006 12:00 AM

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The "brightness" of a hot spot on a PET scan is measured in "Standardized Uptake Values" (SUVs) which range from 0 for no uptake to 15 for maximal uptake. Most cancers are above 2 or 3, but now and then highly metabolic normal tissues can be in this range as well, but usually closer to 2 or 3 than to 15. My advice (you asked) would be to request a consultation with a pulmonologist and have him look over the scans and decide, based on what he sees on the scans and his experiences in the past, whether to wait or biopsy now. If you are a smoker, I would say the odds suddenly are much higher that this may be bad and getting a biopsy might be the right thing to do. Cancer tends to get bigger. If you waited a few months and the nodule was exactly the same size or smaller than it is now, it is less likely to be cancer. If you have a chest xray from the last couple years and the nodule was not present, or was present but smaller, on that chest xray, I would be more suspicious this is cancer. if it is cancer and if it has not spread yet and if you get it diagnosed now it is likely that you could be cured now. if it is cancer and if you wait several months and if during that time it spreads elsewhere, it is unlikely that you could be cured. -Amnia

Pet Scans

by Teddyr on Wed Nov 01, 2006 12:00 AM

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Amnia, Thank you for your thoughts. They were helpful. I did have a chest-x-ray two years ago and it was clear. So, this nodule is something new and frightening. All the docs seem to think it is benign, but they won't rule out cancer. It seems to me that a biopsy would be the best path to follow because it would confirm the status of the nodule - benign or malignant. And if it was malignant, I could have it excised pronto before it metasized. But what throws me is that the radiologist that read the CT and the radiologist that read the PET and my primary care doc all think it is PROBABLY benign and should wait three months for another CT scan to see if is stable. I don't want to over-react and request a biopsy when it isn't indicated. But I don't want to wait and have it growing worse either. Am in a quandry. Also, re. my history, I have never smoked but I did have a malignant melanoma cut out in 1989. It had not metaszied and I did not have to have any chemo or radiation. Thanks again for your thoughts. teddyr

Thoughts

by Amnia on Wed Nov 01, 2006 12:00 AM

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ask your primary care doctor for a referral to a pulmonologist (lung specialist). bring your films. ask him to review the films with you and explain why he thinks it is or isn't malignant. bring your films from 2 years ago to compare. let his decision help guide you in deciding to wait or biopsy. the fact you have never smoked is very much in your favor. if it were not for the otherwise normal PET scan I would worry you with thoughts that it could be some other kind of cancer that had spread to the lung. but generally if it were another cancer that spread to the lung, it would have been reported on the PET. hey, keep us posted. i am going to wish real hard that it is nothing at all! -Amnia
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