This is my father’s PET and CT scan. I didn’t think his condition was this serious. I always had hope. Seeing these results completely devastated me. I feel like I can’t breathe..
F-18 FDG WHOLE BODY POSITRON EMISSION TOMOGRAPHY (PET) REPORT
DIAGNOSIS: Metastatic Tumors of Unknown Primary Origin.
ICD-10 CODE: CB0
INDICATION: Diagnosis
REASON FOR REQUESTING THE EXAMINATION: To investigate the primary tumor in a patient with metastasis of a malignant epithelial tumor.
IMAGING PROTOCOL: The patient's blood glucose level was measured at 115 mg/dl. The patient was injected with 2.5 MBq/kg F-18 FDG.
Until imaging began, the patient rested in a quiet environment without chewing or speaking. Following the injection and the subsequent uptake period, a standard whole-body PET scan covering the vertex-upper thigh region was performed. To improve visualization of the intestinal loops and stomach by opacifying them, the patient was given 25 ml of contrast agent (Omnipol) orally before and after FDG injection. The obtained images were evaluated using CT attenuation correction, and then transaxial, coronal, sagittal plane, and MIP (Maximum Intensity Projection) views were assessed.
RESULTS:
In the head, neck, and thoracic sections, hypermetabolic hypodense lesions were observed, the largest measuring 28x22 mm in the left cervical region. These lesions showed increased FDG uptake (SUVmax: 6.38) in the left cervical region within the longissimus capitis muscle, the right supraspinatus and right subscapular muscles, the posterior section of the left deltoid, the right pectoralis major, and the right latissimus dorsi.
One hypermetabolic lymph node measuring 20x12 mm was observed in the right submandibular space and one in the right axilla, showing increased FDG uptake (SUVmax: 5.56).
Hypermetabolic metastatic nodular densities measuring 15x11 mm were present in the skin and adipose tissue anterior to the right shoulder and bilaterally posterior to the thorax, showing increased FDG uptake (SUVmax: 3.45).
No lymph nodes showing pathological FDG uptake were detected in the mediastinum.
A soft tissue lesion measuring 25x20 mm, sitting in a fissure, was observed in the superior segment of the right lung lower lobe, showing slightly increased FDG uptake (SUVmax: 3.41).
A nodular density measuring 8x7 mm, showing no FDG uptake, was observed in the lingular segment of the left lung.
In abdominopelvic sections; Increased FDG uptake (SUVmax: 5.57) was observed between the left gluteal muscle planes and the posterior proximal muscle planes of the left thigh, with anatomically unclear delimitation.
In the skeletal system, widespread metastatic lesions showing increased FDG uptake (SUVmax: 7.91 left iliac) were observed in the left femoral neck, left acetabulum, both iliac bones, right scapula, both humeral heads, L1, L4 and L5 vertebrae, T12 vertebral spinous process, T5 vertebral right transverse process, T4 vertebral body, posterior elements of T3 vertebral body, T2 vertebral body, right 4th rib lateral surface, right 9th rib posterior surface, and the base of the left maxillary sinus, some with soft tissue components.
The FDG distribution in other areas of the body within the imaging field was within physiological limits.
Results and Recommendations
RESULTS:
- Hypermetabolic hypodense metastatic lesions in the left cervical longissimus capitis muscle, right supraspinatus and right subscapular muscles, posterior section of the left deltoid, right pectoralis major, right latissimus dorsi, between the left gluteal muscle planes, and between the posterior proximal muscle planes of the left thigh.
- One hypermetabolic lymph node in the right submandibular space and one in the right axilla; hypermetabolic metastatic nodular densities in the subcutaneous adipose tissue anterior to the right shoulder and bilateral posterior thorax.
- Soft tissue lesion in the superior segment of the right lower lung lobe showing slightly increased FDG uptake (Primary tumor?).
- Widespread hypermetabolic metastatic lesions in the skeletal system.
The patient was given 25 mg of contrast agent orally (Omnipol).