Clinical History
Case of ca lung. Had chemotherapy from Jan till May 09. On Tarceva since Feb 09. Also had THBSO for ca cervix in Jan 09. PET/CT to assess disease status.
Findings
No FDG-avid focus is demonstrated in the lungs at present. The mass in the right upper lobe is non FDG-avid and is in keeping with treated disease. This is associated with distal band-like/linear atelectasis. The other previously noted subcentimeter lung nodules have largely resolved. Mild scarring is present in the right lung apex. No pleural effusion or pericardial effusion is noted.
No FDG-avid hilar, mediastinal or supraclavicular nodes are noted at present. The non FDG-avid subcentimeter right upper paratracheal node is more in keeping with a treated node. The other non FDG-avid subcentimeter precarinal node as well as the subcentimeter bilateral jugular/cervical nodes of negligible to low grade activity are more in keeping with reactive nodes.
A dedicated brain study was not performed. However no focal area of abnormal increased metabolic activity is detected to suggest presence of FDG avid metastatic disease in the cerebral hemispheres or cerebellum.
There are no FDG-avid intra-abdominal or retroperitoneal nodes. Tiny gallstones are present. No abnormal FDG-avid focus is noted in the liver, spleen, pancreas or adrenal glands. The patient is status post hysterectomy.
The lytic focus in the left ilium is non FDG-avid and is more in keeping with a treated metastasis. There is a FDG-avid focus involving the right ischium (maxSUV 12.0). The focus of low grade to mildly increased FDG activity involving the right inferior pubic ramus is in keeping with a healing fracture.
Clinical Impression
The lung mass in the right upper lobe is non FDG-avid and is in keeping with treated disease.
The non FDG-avid subcentimeter right upper paratracheal node is more in keeping with a treated node.
The lytic focus in the left ilium is non FDG-avid and is in keeping with a treated metastasis. However, there is a FDG-avid active metastatic bone focus involving the right ischium.
No FDG-avid metastatic foci are seen elsewhere.
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