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Can results vary with different scan methods?

littlemac's picture
Posts: 22
Joined: Nov 2014

Hi!  It has been 1 year since I received the news that my Follicular Lymphoma was in complete resolution. I had received 2 PET Scans- one with the iinitial diagnosis and one after 4 treatments with Bendamustine and Ritauximab.  One year later, my doctor did a CAT scan (my first). In the findings they said that one of the lymph nodes in my groin appears to be growing again, but it may also be accounted for by the different testing methods.  My doctor made a note that he will continue the Ritauxun Maintanence treatments as we are doing now and do another CAT Scan in 6 months.  

I will be talking to my doctor about the results in the next couple of days when I get my treatment, so I expect to get a little more feedback.  I am just wondering if anyone else has had a similar experience.

Max Former Hodg...
Posts: 3699
Joined: May 2012

Welcome, littlemac.

Numerous members here have done the B&R treatment you received, and/or maintenance regimens, so you will have a lot of responders with first-hand information.

A node's size should be convertable from one scan to another, but I suppose the confusion is possible.  Many scanners now are combined CT/Pet machines, doing both sets at once.  Your oncologist should absolutely be able to give you a definitive answer to your question when you meet. Although confusion between biopsies is fairly common, I cannot recall your question regarding a possible discrepancy between a PET vs CT image occuring before. 

I hope you have the answer soon, and that the answer is that there is no real indication of node enlargement.



littlemac's picture
Posts: 22
Joined: Nov 2014

Thank you all for your opinions on this.  I will see what my doctor says tomorrow.


Anonymous user (not verified)

I have the CDs of all my many CT/PET/MRI scans and have viewed them in detail. Some things are visible and painfully obvious on x-ray/scans, even to a novice like me. However I once heard someone in the profession say that reading scans with subtle, less than obvious features, is similar to seeing faces in the clouds . Where one sees a dog another may look at the same cloud and see a fish. Its as much of an art as a science. So what can one do? The key is consistency. Try to have all scans at the same facility and read by the same radiologist and look for changes. This is especially true with low-grade lymphoma which does not show up well in any type of imaging. If you have an iPad I recommend getting the cancer management handbook app. It's free and goes into great detail about follicular lymphoma. I know of no source for good readable info an imaging, however there are libraries of images of specific conditions readily available. Get a Doctor whose judgement you trust. It is not necessary to "like" a doctor. It is more important to have faith in their knowledge and abilities. And get several opinions.

Best of luck.

Anonymous user (not verified)

My short answer would be yes. I say that because my two PET scans have been overlaid with a CT scan to help position the glowing nodes seen in the PET. They work hand in hand. Neither one is perfect by any means. Low grade lymphomas are often hard to image with a high degree of confidence.

lindary's picture
Posts: 711
Joined: Mar 2015

When I was diagnosed with Follicular lymphoma it was because of an enlarged node in my abdomen. So large it was felt by my Prim Dr. After 6 sessions of R-Chop it was reduced but still larger than it should have been so I then went through 3 rounds of RICE. After that the CT scan showed the node size had gone down but was still slightly enlarged. The PET scan showed no cancer. My Oncologist told me that the node was probably swollen from all of the chemo and should go down over time. 

If you had not done so already, read up on how the lymph system works. Swollen nodes are what happens when that system is working. Unfortunately they can also be swollen when the system is affected by cancer. That is why the Drs use the CT & PET scans to determine the real status of the lymphoma.



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