PET scan uptake value

I'm at work so I can't look in my files to be accurate about my PET scan reports but I can tell you that I continue to have ongoing issues with inflammation which will read with a higher than optimal SUV.  On the scan I had in October that area had a higher SUV than it did in April of last year.  This prompted a biopsy which showed no cancer.   It could be radiation, inflammation, infection, irritation.  I think it's good that you're going to your surgeon.  Although I don't relish going in for an outpatient surgery for the biopsy I think I'd rather do that than wait for another scan 6 months down the line.  But that's me - I am a huge worrier and all of my doctors know it.  I know that the tumor lit up lilke Christmas with an SUV of 22 so the values of 4.1 and 7 and I forget what else should be reassuring to me that I am not having a recurrence.  After my recent visit with my rad onc she said she'd order a scan for March and then as we talked about problems I'm having with occasional bleeding she suggested that if I've had a bad episode of bleeding I should be sure to schedule the scan for at least a month after because the inflammation and bleeding can cause a higher SUV.

So you should probably not be overly concerned (easy for someone else to say!) but seeing the surgeon is a really good idea.

As my radiologist friend has told me several times, PET scans are good and PET scans are bad.  The good thing is that they can pick up cancer cells that other scans cannot.  The bad thing is that they also pick up things such as radiation damage, inflammation, brown fat, etc. and reflect it as an increased SUV.  Perhaps 3 is the number considered abnormal in someone who has not had previous radiation treatment, but for those of us who have had treatment, we may register a higher number.  My first post-treatment PET scan had an SUV of over 4 and I nearly freaked out.  Obviously, it was not a recurrence, as I am still here 5 1/2 years later.  I would tell you not to worry about this, but if you are like me, you will anyway.  I hope your doctors can give you some reassurance that this is not indicative of a recurrence.  Please keep us posted. 

Krissy59 said:

MP327

Thank you for your reply. My oncologist was not concerned and said basically the same thing as you but he did want me to go ahead and see my colorectal surgeon at a 3 months visit instead of my already scheduled follow up that was 6 months from the last visit. You are correct about the worrying, I really try not to let things worry me but it is so hard not to worry about every little thing. I don't see the CR surgeon until mid April, but I will keep everyone updated.

Thanks!

Hello, My suv was 4.1 at my 1st pet post tx and my oncologist said inflammation and radiation will cause the higher suv.  I had follow up exams that showed the cancer was gone.  I completed tx on 6-30-09.  I am fine today.  I wish you well.  Lori  

Krissy59 said:

Pet scan confused

I had a regular follow up appointment at my radiation oncologist a couple of weeks ago and the nurse asked if I had had any recent scans or exams. I told her that my last scan showed an increase in the uptake value and she sighed like she was upset. I told her it was 3.0 and that my colorectal surgeon was seeing me frequently to monitor but that he did not see anything concerning. She said that a 3.0 was not bad and that it made her feel better to know the number. I ask if she had my other scan reports and she said yes. I told her that I wanted to see them. The previous scan's uptake value was 2.1, instead of 2.5, like i had been told. All of the doctors have told me that 3.0 is considered "clinically significant" but that active cancer has uptake values much higher, like 7,8, etc. and that is why they are not too concerned about my last scan results. Well, I finally saw my original pet scan that was done right after I was diagnosed and the area where the cancer was located only had an uptake value of 2.9! So now, 1 year after diagnosis and treatment, it is higher but no one is really concerned. So it went from 2.9 at diagnosis, to 2.1, 10 weeks after completion of treatment, to 3.0, 6 months later. It has me so confused and worried. They all tell me to watch for signs and symptoms like bleeding, pain, and itching. I have always had those and when I tell them that, they say it is related to radiation and that if it were related to cancer it would occur more frequently...although it was always mild and intermittent when I had cancer. When I tell them all these things, they say it is because my tumor was so small. But no matter how small, it had already spread to my inguinal node! This is so frustrating and confusing!

I can certainly understand your confusion and concern.  I will tell you that my PET scans post-treatment (and I've had quite a few) always came back showing some activity in the anal area and the numbers were not all that low.  However, I am approaching 6 years since my diagnosis date and am doing just fine.  There are things that can show up as activity on a PET scan, including radiation damage and inflammation.  I also had "brown fat" in my clavicle area that registered with uptake.  Again, it may just be that those of us who have had radiation to that area will always have a slightly elevated SUV number.  That would be a very good question for your radiation oncologist. 

1st petscan   suv  uptake 8.4 very anxious could  it be a  miracle  mistake  infection

topaz915 said:

petscan suv high

1st petscan   suv  uptake 8.4 very anxious could  it be a  miracle  mistake  infection

My staging PET scan was around that same suv uptake level.  I was diagnosed with anal cancer in June 2008.  I hope your doctors are on top of this and I wish you all the best.

Martha