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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8770
Experience:  Doctor of Medicine
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New low attenuation segment 6 lesion . Lesion does not show

Customer Question

New low attenuation segment 6 lesion . Lesion does not show FDG uptake and has SUV max of 2.8.this is compAred to the background liver uptake with SUV Max up to 3.4.
There is however 16mm focus of intense tracer uptake peripherally in seg 6neith SUV Max of 5.2. A co registered ct lesion is not seem.
Appearances are suspicious for a seg 6 liver metastasis.the exophytic seg 6 lesion on previous ct is not particularly fdg avid.
As this is a new finding this should be regarded as suspicious for a metastasis .
Uptake in the mediastinal/hilar nodes is more indeterminate . This
Could
Be mets or represent a sarcoid like reaction .
Can I have this pet scan report explained plz ?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. SH replied 2 years ago.
Dr. Shahzad MD :

Hi there. Thank you for your question. I will be helping you out with your queries

Dr. Shahzad MD :

What they are trying to say in this PET scan report is that the lesion that they previously saw on the CT scan is not a metastasis i.e. the 15 mm lesion that you previously described is not a liver metastasis (most likely). But they see another lesion in the liver (which is not seen on the CT scan, but seen on the PET scan) that is 16 mm in size and is also in the periphery of the liver and is most likely a liver metastasis.

Dr. Shahzad MD :

So you do have a liver metastasis according to the PET scan report which is in fact different from the lesion seen on the CT scan initially.

Dr. Shahzad MD :

For the lymph nodes they are saying that they are not sure if this is due to metastasis or something else but they do say that there is some uptake in the lymph nodes as well which means there may be a suspicion of metastasis there as well but not sure.

Dr. Shahzad MD :

Let me know if you have more questions.

Dr. Shahzad MD :

Rate me when you are done.

Customer:

Hi thx alot . I was very confussed by the report . So it's nit the same lesion as pet the previous ct report ? So what was that lesion on the ct report ? And whaT can be done re the nodes to find if they have mets in them as we want to start treatment ASAP ?

Dr. Shahzad MD :

The only way to know for sure is biopsy.

Customer:

For the met they say surgery or microwave but my worry is the nodes too . Which nodes are they in the body ?

Dr. Shahzad MD :

The lesion previously reported on the CT scan is most likely not a metastasis, we do not know what it is unless a biopsy is done.

Dr. Shahzad MD :

The nodes that they are talking about are the nodes around the major blood vessels i.e. the aorta and the inferior vena cava

Customer:

So there are 2 diff lesions they are talking about ?

Dr. Shahzad MD :

Yes

Dr. Shahzad MD :

two different lesions

Dr. Shahzad MD :

One of them is a metastasis and the other one is most likely not a mets

Customer:

That's very strange as the lesion on ct was thought to be a met but them Infact it's not and Znother one found instead.

Dr. Shahzad MD :

Yes

Customer:

So what could the other one be ?

Dr. Shahzad MD :

We do not know but it does not look like a met

Customer:

What does it mean by not seen on co- registeted ct ?

Dr. Shahzad MD :

Actually when they read the report of the PET scan, they do a CT scan simultaneously as well. So they compare the lesions on the PET scan and the CT scan to see if we can see something on the PET scan and the CT scan at the exact same spot.

Customer:

Should they not do a biopsy of the actual met invs

Dr. Shahzad MD :

Not seen on the co-registered CT means that they saw something on the PET scan on the liver at a spot where there was nothing found on the CT scan on the same spot.

Customer:

Shud they not do a biopsy as this may not b met too?

Dr. Shahzad MD :

Well, that is up to them, a biopsy, although difficult, could be possible.

Dr. Shahzad MD :

You should discuss this with your doctor

Dr. Shahzad MD :

I mean the biopsy thing.

Dr. Shahzad MD :

But a PET scan is very accurate in detecting mets

Dr. Shahzad MD :

So I am pretty sure that the lesion that was discovered on the PET is a met in the liver

Customer:

But as there was uptake that is a met right ? How cum

Customer:

How cum this was not seen on ct Scan which was 1 6 mm and the 15 mm lesion was seen ?

Dr. Shahzad MD :

In a PET scan they use radiolabelled glucose. Cancer cells take up far more glucose than other parts of the body. So if there is a mets it will take up this radiolabelled glucose far more than other parts of the body and it will glow.

Dr. Shahzad MD :

This is exactly why a PET scan is done. CT quite often misses things which PET scan picks up.

Customer:

Y coujd this 16 mm not have shown on the ct?

Dr. Shahzad MD :

Yes it is possible for CT to miss things

Customer:

So what can we do about this nodes ? I'm worried they may well have mets if there was uptake right.

Dr. Shahzad MD :

I can't explain why CT missed it but the fact is that it was missed

Customer:

Good job they did pet as other wise this non met lesion may have been treated and we may not have known nothing about the 16 mm met right?

Customer:

So even though no other mets seen at present. , could they still b too tiny too be seen on pet in other parts? I'm just worried that it travelling ( the cells ) through the body. ?

Dr. Shahzad MD :

I understand your concerns.

Dr. Shahzad MD :

The next best thing to do is to wait for your oncologist opinion and the surgeon's opinion and go along with that. Just let the experts do the thinking.

Dr. Shahzad MD :

Please rate me for my services by clicking on one of the smilies below.

Dr. Shahzad MD :

thank you.

Expert:  Dr. SH replied 2 years ago.

Please rate me for my services before we proceed.

Thank you.

Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8770
Experience: Doctor of Medicine
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