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PET Scans

Anonymous user (not verified)

Okay . . . so I'm having a bit of trouble understanding how/why my Terry's initial PET scan showed 4 or 5 lymph nodes with lymphoma and the two that were removed from his abdomen near the tumor (aka:  "em'effer", as we refer to it), didn't show any involvement when they were biopsied.  He has one in his neck, one in his chest, one near his pelvis, one in his abdomen and, I believe one other I can't recall where it was that were all "lymphomized" . . .

How could the two, so near the tumor, have been cancer free and all those others affected by malignancy?

Does anyone else have a history like this?  If so, was the mid-way/follow-up PET clear?  If not, did they continue with the R-CHOP or change the treatment plan to more aggressive chemo drugs?

Trying to understand the significance/prognostic value of those two nodes they removed with the tumor that were clear and what we may expect at the end of the month when they do the repeat scan.

Thanks!

Anonymous user (not verified)

Okay, since posting the previous question, I came home and looked at Terry's first PET scan results.  I realize the higher the SUV, the more cancer present in a particular area.  When someone who knows more about this stuff has time, could someone interpret the following and give me your thoughts on what I'm reading?

He has a 14 mm enlarged jugular lymphy node (in his neck, I know) that "demonstrated marked FDG avidity with a maximal SUV of 7.78".  My interpretation of that is that it was not huge in size but with that amount of uptake it tells me there is a significant amount of cancer in it, right?

Reading on, he has an "enlarged porta hepatic lymph node that demonstrates marked FDG avidity with a maximal SUV of 15.55".  My interpretation is that they saw an enlarged liver lymph node (doesn't give the size, which is odd), but it has a pretty substantial SUV of 15.55, meaning (again) there is a substantial amount of cancer in it, right?

Then, there were nonenlarged inguinal lymph nodes (his groin), that only had an SUV of 2.03 on the left and 1.28 on the right . . . not of great concern, right?

Right lower abdomen had a nonenlarged lymph node "demonstrating a maximal SUV of 6.9", odd in that the lymph node there wasn't enlarged, yet had the elevated/concerning 6.9 SUV . . . What in the sam hill does that mean???  There is cancer there in the mucosal lining/peritoneum?  That's how I'm interpretting that.  Is that possible?

The other thing I'm thinking is of concern is that "at the midline umbilical area, there is an area with a maximal SUV of 6.27".  No lymph node is mentionted there.  Again, doesn't that mean there is some sort of mucosal/peritoneal malignancy there?

Here's the most concerning to me . . . They noted, "a markedly enlarged lymph node within the inferior and lateral aspect of the pericardial fat on the right side that measured 2.3 x 1.8 cm and demonstrated marked FDG avidity (maximal SUV of 29.3).  Whoa Nellie . . . not a HUGE node, but obviously enlarged with a WHOLE LOT of malignancy, right?

My concerns are as follows:  1)  A whole lot of malignancy noted in the enlarged nodes that, hopefully, will have responded to the RCHOP by the time they run the next scan; but 2) What in the "H" does that business mean when they mention all that uptake in areas where there weren't any enlarged lymph nodes there?

Anyone with any knowledge about all this care to comment . . . if there IS anyone out there in this forum with any experience or smarts with this stuff who can explain it?

Would appreciate whatever information anyone has on this mumbo jumbo . . . 

Thanks!

yesyes2
Posts: 567
Joined: Jul 2009

I'm not sure but I don't think the amount of SUV has anything to do with the amount of cancer cells present.  I know that in aggressive lymphomas the SUV is considerably higher than in indulent types.  The size of the nodes does have to do with the amount of cancer cells present plus the inflamation caused by disease.  I think you would really benefit from having a conversation with the reading radiologist about the PET scan.  Or wait until the next scan and have an in person meeting with the radiologist to go over the new results.  Or ask your oncologist to explain everything to you.  Best to keep in mind that we are all just lay people.

 

Anonymous user (not verified)

Thanks, Yes, yes.  I plan on talking about what it all means with them when we see them again on the 26th.  I just thought someone's personal experience with some of this would help me better prepare my questions if I had a little insight from anyone with similar results.

I'm sure most everyone who comments here doesn't expect a professional opinion of any sort.  I certainly don't.  But, from the other bits of information people share here . . . I (and I would wager quite a few others) find that personal side of things just as helpful, if not moreso, than what doctors share in a limited time setting at the clinic.

Thanks!

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