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Ct-pet report post surgery and completion of adjuvant chemo

sdp's picture
sdp
Posts: 138
Joined: Jan 2012

This is my report after the surgical resection of colon , and liver and RFA of two tumors.

This is after completion of adjuvant chemo, which was basically completing balance of 12 cycles of FOLFOX and erbitux.

It been only 3 months post surgery .
I am much worried as there is increase in FDG uptake in liver at three spots and at the same time cancer markers are within limits.

The Ct pet report as follows ;

Post surgical and RFA changes in the liver .

Three focii of increased FDG uptake in liver

segment ii (SUV max 4.2)
Segment iv ( SUV max 5.7)
Segment v ( SUV max 4.9)
With underlying calcification

No abnormal focus of increased FDG uptake at the resected margin of segment vii of liver.

Post operative changes in colon region. No abnormal focus of increased FDG uptake is seen at
Anastomotic site.

Diffused increased uptake in the surgical incision located over the right side of abdomen ( post operative inflammation )
Low grade FDG avid cm sized right auxiliary node ( SUV max 2) ---- non specific
No demonstrable lung nodule
No FDG avid  skeletal lesion

No FDG avid or size criteria wise significant adenopathy in neck,
Mediastinum , and retroperitoneum regions
Rest of Ct -Pet is unremarkable with physiological distribution of FDG.

Impression.
----------------

As compared to previous PET-CT scan dated 12 may 2012 the present study shows ;

1. Post surgical and post RFA status.

2. Three foci of increased FDG uptake in segments 2, 4a and 5 of liver with underlying calcifications.

3. Detection of focal FDG uptake in above mentioned areas even after 3 months post operative
RFA Period remains concerning for active disease and hence close follow up PET-CT scan is essential to ascertain etiology.

4. No evidence of metabolically active disease at the anastomotic site of colon.

-----------------------------------------------------------------------------------------------------

Current cancer markers as follows ;

CEA at dx 935 , CEA on 15 nov 2012 is 1.6 ( was 2.5 in October 2012)

CA 19-9 at dx 1200 , on 15 nov 2012 is 8.8 ( was 8.6 in October 2012)

Can anyone guide or help me put my worries to rest or whatever. Have two days to go before I consult my oncologist with this report.

Thanks in anticipation of a reply

Lovekitties's picture
Lovekitties
Posts: 2893
Joined: Jan 2010

I can understand your concerns and confusion when the report talks about increased uptake in the liver while the CEA seems to be decreasing. It is difficult to understand when it appears your CEA has been an indicator in the past of disease and now is in the normal range.

I guess if it were me I would ask if the underlying calcification could be a positive thing regarding the three liver spots noted.

I would also want to follow the advise given at the end of the report to have close follow up to determine if there is additional uptake or growth in those three spots and the right auxiliary node.

Unfortunately it looks like a wait and watch, but of course your oncologist will have the best knowledge of what this all means.

Try not to worry overly much. Whatever all this means medically, I am sure you and your doc will come up with a plan for you to make best progress.

Marie who loves kitties

Chelsea71
Posts: 1167
Joined: Sep 2012

Hi

I agree with Marie. The calcification could be a positive thing. The majority of the report looks very positive. Bones, lungs and peritoneal cavity are good. The liver is very treatable. Seems to be numerous options when it's contained only to the liver. Try not to drive yourself crazy over it. I would try to put it out of my mind until the app. with the onc. (That's not true. I would obsess over every single word until I became physically ill). LOL. Worrying will not change the outcome. If there is cause for concern, you and your onc will work out a good plan. Stay on top of the scans and take one day at a time. I realize that's easier said than done. I know from my husbands experience how discouraging it is to go through a big surgery and then be slapped with potentially bad news. Your situation doesn't sound all that bad. I think it will work out okay. Hang in there.

Chelsea

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