EXAMINATION: PET/CT imaging skull base to mid thigh.
INDICATION: 64-year-old female with newly diagnosed left breast cancer.
PET/CT REQUESTED FOR: initial treatment strategy and detection of possible metastatic disease.
CORRELATIVE STUDIES: mammogram Feb 1, 2012. Demonstrates a 3 cm mass in the left upper outer quadrant.
TECHNIQUE: following the intravenous injection of 13.8 mCi 18 – fluoro – 2 – deoxyglucose (FDG) and a 70 min. delay to allow for uptake of the tracer, images were obtained from the skull base to the midthigh on the GE Discovery LS Fusion PET/CT scanner, along with 3-D reconstruction. Oral contrast was administered and CT scanning was performed through the same area for the purpose of attenuation correction utilizing a GE Lightspeed Multi-detector scanner. Blood glucose at the time of injection was 88 MG/DL. The SUV – max of the liver is 2.7.
FINDINGS: there is normal physiologic uptake of the FDG radio tracer identified within the tonsils, salivary glands, liver, spleen, myocardium, genitourinary and gastrointestinal tracts.
HEAD/NECK: there is a 1.5 cm focus of mild hypermetabolic activity in the right lobe of the thyroid gland, SUV 6. There is no hypermetabolic lymphadenopathy in the neck.
CHEST: there is a 2.5 cm hypermetabolic mass in the lateral aspect of the left breast extending to the skin, SUV 11.3. Bilateral apical fibrosis is present. There are no pulmonary nodules. There is no hypermetabolic axillary, mediastinal, or hilar lymphadenopathy.
ABDOMEN/PELVIS: Cholelithiasis is present. The right kidney contains a 1.7 cm parapelvic cyst. PET and CT images of the left kidney, liver, spleen, adrenal glands, and pancreas are grossly normal. There is no hypermetabolic lymphadenopathy or ascites in the abdomen and pelvis.
SKELETON: there are no areas of abnormal hypermetabolic activity in the skeleton suggestive of neoplasia.
1. The hypermetabolic left breast mass is consistent with neoplasm.
2. The hypermetabolic focus in the thyroid gland may be an adenoma or carcinoma.
If you've made it this far, I congratulate you on slogging through all the multisyllabic words that they include. I do find it all rather fascinating, though, don't you?
The future looks like this: first, I need to get a needle biopsy on the thyroid. I'm hoping that it's benign. If it's not, then I need to find out what my options are for that. I'll also have to schedule with the surgeon to get a lumpectomy done and have the tumor in the breast removed.
Are we having fun yet?