OK, a bit of an update: I had a consult with another liver surgeon at another hospital (UNC in Chapel Hill) and a PET scan was recommended, preferably before my chemo started. Evidently there was a chance that some of the lesions found might not actually be living or active, and a PET scan would help determine the extent of my disease by showing the active tumors.
So I went in 2 days ago for the scan and below are the notes from the findings. As with most of you I don’t speak doctor, but I’ve bolded a few phrases below that lift my spirits and confirm why I’ve been feeling as good as I have. I do find it interesting that in referring to where these lesions are being found, the caudate is mentioned but the right lobe of my liver isn’t. Does this mean there’s no living tumors in the right side of my liver?
I’ll post next week to relay what this all means, as I want to discuss these results with my oncologist before I get my hopes too far up. My third round of chemo officially starts this coming Monday, and suddenly I’m ready for it now.
Have an awesome weekend, and thank you for your continued energy…. glancing at these results, I believe it appears to be working.
Procedure: F-18 FDG PET/CT scan from the skull base to the mid thighs.
Indication: Male, 46 years old. C20 Malignant neoplasm of rectum (HCC), C78.7 Secondary malignant neoplasm of liver and intrahepatic bile duct (HCC), Restaging CT- rectal cancer Subsequent treatment strategy.
Radiopharmaceutical: 13.41 mCi of F-18 FDG, intravenously.
Blood Glucose level prior to FDG injection: 77 mg/dL.
Time from injection to imaging: 58 minutes.
Technique: PET/CT imaging was performed from the skull base to the mid thighs using routine PET acquisition following evaluation of serum glucose level and intravenous administration of F-18 FDG, per standard protocol. A CT scan was performed for localization and attenuation correction purposes only and is not intended for diagnosis separate from the PET scan.
Prior Imaging studies: CT CAP 1/3/2017
Head/Neck: Physiologic FDG activity is identified in the pharyngeal musculature, tonsils, and salivary glands. Small cervical lymph nodes are noted without abnormal FDG accumulation. No abnormal FDG activity within the neck. No metabolically active cervical masses.
Chest: No metabolically active mediastinal, hilar, or axillary lymphadenopathy. No metabolically active pulmonary masses or nodules. No abnormal FDG activity within the chest. Tiny right lower lobe nodule (image 156).
Abdomen / Pelvis: There are multiple abnormal foci of FDG activity in the caudate and left liver, as described on recent CT. SUV max of the caudate lesion is 8.4. SUV max of the subcapsular left lateral hepatic lobe (image 176) is 7.7. Multiple calcified lesions do not demonstrate abnormal metabolic activity. There is a small focus of increased activity near the gallbladder fossa (image 195). Borderline enlarged gastrohepatic lymph nodes have mildly increased activity, SUV max 3.7 in image 183. Focal uptake in the sigmoid colon (image 303) has SUV max 28.8.
Osseous: No aggressive lesions. No abnormal osseous FDG activity.
1. Low-attenuation lesions in the left hepatic lobe and caudate have focally increased and abnormal metabolic activity. These are suggestive of hepatic metastases. Densely calcified hepatic lesions do not demonstrate significantly increased activity.
2. Mildly increased activity in borderline enlarged gastrohepatic lymph nodes are nonspecific, although concerning for metastatic involvement.
3. Focal uptake in a sigmoid colon mass, in keeping with known primary neoplasm.
4. Focal uptake in the region of the gallbladder fossa may represent misregistered FDG uptake in a gallbladder metastasis (as was described on recent contrast enhanced CT scan), though exact localization is difficult. This could also represent a small adjacent hepatic lesion. Attention on followup.