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What Does My PET And CT Report Indicate?
Question: i Had a pet/ct.
can you review and give your view
TUMOR IMAGE PET/CT SKUL-THIGH (CPT=78815) - Details
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About This Test
Details
Study Result
WHOLE BODY PET-CT, 2/26/2015.
COMPARISON STUDIES:
CT of the abdomen and pelvis, 5/9/2014.
CLINICAL HISTORY:
Transitional cell adenocarcinoma of the urinary bladder, stage II..
Cystitis cystica.
IMAGING PROTOCOL:
Whole body PET-CT images were obtained, scanning from the skull base to the proximal femurs, 60
minutes following the uneventful intravenous administration of 12.6 mCi of Flouorine-18 FDG,
including a low-dose noncontrast CT scan, for localization-fusion purposes, followed by 2-D axial
PET images, supplemented by reformatted coronal and sagittal fused PET-CT images.
Automated exposure control and ALARA manual techniques for patient specific dose reduction were
followed while maintaining the necessary diagnostic image quality.
ADVERSE EFFECTS:
None.
FINDINGS:
THE NECK:
The nasopharynx, oropharynx, and hypopharynx maintain grossly normal nonenhanced CT appearances,
without definite discrete hypermetabolic lesions.
The parotid and submandibular glands are normal and symmetrical in size, without discrete
hypermetabolic lesions.
The larynx has a normal CT appearance, without definite focal nonenhanced CT abnormalities or
discrete hypermetabolic lesions.
No pathologically enlarged or hypermetabolic cervical or supraclavicular lymph nodes are present.
The thyroid gland is normal in size, without definite dominant solid nodules or discrete
hypermetabolic lesions.
THE THORAX:
No suspicious hypermetabolic pulmonary nodules are detected.
The lungs are normal in volume, without airspace consolidation or pleural effusions.
The thoracic aorta and central pulmonary arteries are normal in caliber; the heart chambers are
normal in size, without pathological hypermetabolic pericardial radiotracer uptake or a pathological
pericardial effusion; multivessel calcified coronary plaque is present.
No pathologically enlarged or hypermetabolic axillary, mediastinal, hilar, or cardiophrenic lymph
nodes are present.
THE ABDOMEN:
The liver is normal in size and morphology, demonstrating homogeneous parenchymal attenuation and
normal heterogeneous physiological tracer uptake, without definite discrete focal parenchymal CT
abnormalities or pathological hypermetabolic foci that exceed a 2:1 ratio, in comparison to the
normal hepatic parenchyma.
The pancreas is normal in size and morphology, demonstrating homogeneous glandular attenuation,
without definite discrete focal CT abnormalities or pathological hypermetabolic foci.
The spleen is normal in size and attenuation, without pathological hypermetabolic foci.
Stable bilateral adrenomegaly is redemonstrated, consistent with adrenal hypertrophy, without
dominant nodules or pathological hypermetabolic foci.
The kidneys are normal and symmetrical in size and cortical thickness, without pyelocaliectasis or
perinephric stranding; both kidneys demonstrate homogeneous nephrographic attenuation, without
definite discrete solid lesions.
Diffuse aortoiliac atherosclerosis is present, without aneurysmal dilatation.
No pathologically enlarged or hypermetabolic retroperitoneal lymph nodes are present.
THE PELVIS:
The urinary bladder is partially distended, demonstrating mild-moderate circumferential wall
thickening, accompanied by intense edematous perivesical fat stranding, without discrete
intraluminal filling defects; a small diverticulum is present along the left lateral bladder wall.
Mild prostatomegaly is present, associated with multiple similar foci of intense hypermetabolic
radiotracer uptake along the peripheral zone.
No pathologically enlarged or hypermetabolic pelvic or inguinal lymph nodes are present.
The small and large bowel are normal in caliber and wall thickness, demonstrating extensive sigmoid
diverticular formation, without discrete hypermetabolic intraluminal lesions or edematous
mesenteric-pericolic fat stranding.
No pelvic ascites is present.
THE SKELETAL SYSTEM:
The cervicothoracolumbar vertebra maintain normal heights, without discrete blastic or lytic
vertebral lesions or discrete hypermetabolic foci.
No discrete hypermetabolic osseous lesions are detected along the thoracic cage, the proximal
humeri, or the proximal femurs.
=====
IMPRESSION:
1. Mild-moderate circumferential wall thickening of the urinary bladder wall, accompanied by
intense edematous perivesical fat stranding, collectively reflecting the clinical history of
cystitis cystica, without discrete intraluminal filling defects.
2. Multiple similar foci of intense hypermetabolic radiotracer uptake along the prostatic
peripheral zone, highly suspicious for multifocal prostatic carcinoma; the differential diagnosis
does include multifocal prostatitis.
3. No PET/CT evidence of remote hepatic, pulmonary, or osseous metastases.
4. No PET/CT evidence of hypermetabolic pelvic nodal disease.
5. Coronary atherosclerosis.
6. Diffuse aortoiliac atherosclerosis, without aneurysmal dilatation.
7. Extensive sigmoid diverticular formation.
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MyChart® licensed from Epic Systems Corporation, © 1999 - 2013.
can you review and give your view
TUMOR IMAGE PET/CT SKUL-THIGH (CPT=78815) - Details
Printer friendly page--New window will open
About This Test
Details
Study Result
WHOLE BODY PET-CT, 2/26/2015.
COMPARISON STUDIES:
CT of the abdomen and pelvis, 5/9/2014.
CLINICAL HISTORY:
Transitional cell adenocarcinoma of the urinary bladder, stage II..
Cystitis cystica.
IMAGING PROTOCOL:
Whole body PET-CT images were obtained, scanning from the skull base to the proximal femurs, 60
minutes following the uneventful intravenous administration of 12.6 mCi of Flouorine-18 FDG,
including a low-dose noncontrast CT scan, for localization-fusion purposes, followed by 2-D axial
PET images, supplemented by reformatted coronal and sagittal fused PET-CT images.
Automated exposure control and ALARA manual techniques for patient specific dose reduction were
followed while maintaining the necessary diagnostic image quality.
ADVERSE EFFECTS:
None.
FINDINGS:
THE NECK:
The nasopharynx, oropharynx, and hypopharynx maintain grossly normal nonenhanced CT appearances,
without definite discrete hypermetabolic lesions.
The parotid and submandibular glands are normal and symmetrical in size, without discrete
hypermetabolic lesions.
The larynx has a normal CT appearance, without definite focal nonenhanced CT abnormalities or
discrete hypermetabolic lesions.
No pathologically enlarged or hypermetabolic cervical or supraclavicular lymph nodes are present.
The thyroid gland is normal in size, without definite dominant solid nodules or discrete
hypermetabolic lesions.
THE THORAX:
No suspicious hypermetabolic pulmonary nodules are detected.
The lungs are normal in volume, without airspace consolidation or pleural effusions.
The thoracic aorta and central pulmonary arteries are normal in caliber; the heart chambers are
normal in size, without pathological hypermetabolic pericardial radiotracer uptake or a pathological
pericardial effusion; multivessel calcified coronary plaque is present.
No pathologically enlarged or hypermetabolic axillary, mediastinal, hilar, or cardiophrenic lymph
nodes are present.
THE ABDOMEN:
The liver is normal in size and morphology, demonstrating homogeneous parenchymal attenuation and
normal heterogeneous physiological tracer uptake, without definite discrete focal parenchymal CT
abnormalities or pathological hypermetabolic foci that exceed a 2:1 ratio, in comparison to the
normal hepatic parenchyma.
The pancreas is normal in size and morphology, demonstrating homogeneous glandular attenuation,
without definite discrete focal CT abnormalities or pathological hypermetabolic foci.
The spleen is normal in size and attenuation, without pathological hypermetabolic foci.
Stable bilateral adrenomegaly is redemonstrated, consistent with adrenal hypertrophy, without
dominant nodules or pathological hypermetabolic foci.
The kidneys are normal and symmetrical in size and cortical thickness, without pyelocaliectasis or
perinephric stranding; both kidneys demonstrate homogeneous nephrographic attenuation, without
definite discrete solid lesions.
Diffuse aortoiliac atherosclerosis is present, without aneurysmal dilatation.
No pathologically enlarged or hypermetabolic retroperitoneal lymph nodes are present.
THE PELVIS:
The urinary bladder is partially distended, demonstrating mild-moderate circumferential wall
thickening, accompanied by intense edematous perivesical fat stranding, without discrete
intraluminal filling defects; a small diverticulum is present along the left lateral bladder wall.
Mild prostatomegaly is present, associated with multiple similar foci of intense hypermetabolic
radiotracer uptake along the peripheral zone.
No pathologically enlarged or hypermetabolic pelvic or inguinal lymph nodes are present.
The small and large bowel are normal in caliber and wall thickness, demonstrating extensive sigmoid
diverticular formation, without discrete hypermetabolic intraluminal lesions or edematous
mesenteric-pericolic fat stranding.
No pelvic ascites is present.
THE SKELETAL SYSTEM:
The cervicothoracolumbar vertebra maintain normal heights, without discrete blastic or lytic
vertebral lesions or discrete hypermetabolic foci.
No discrete hypermetabolic osseous lesions are detected along the thoracic cage, the proximal
humeri, or the proximal femurs.
=====
IMPRESSION:
1. Mild-moderate circumferential wall thickening of the urinary bladder wall, accompanied by
intense edematous perivesical fat stranding, collectively reflecting the clinical history of
cystitis cystica, without discrete intraluminal filling defects.
2. Multiple similar foci of intense hypermetabolic radiotracer uptake along the prostatic
peripheral zone, highly suspicious for multifocal prostatic carcinoma; the differential diagnosis
does include multifocal prostatitis.
3. No PET/CT evidence of remote hepatic, pulmonary, or osseous metastases.
4. No PET/CT evidence of hypermetabolic pelvic nodal disease.
5. Coronary atherosclerosis.
6. Diffuse aortoiliac atherosclerosis, without aneurysmal dilatation.
7. Extensive sigmoid diverticular formation.
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MyChart® licensed from Epic Systems Corporation, © 1999 - 2013.
Brief Answer:
You do not have distant metastasis
Detailed Answer:
Hello
Thanks for posting PET/ CT report.
I have gone through the entire report and threads of our previous discussions .and noticed that it has not spread to distant organs or lymph nodes either locally or in para aortic lymph nodes.
Bladder shows changes of Cystitis Cystica which is a common feature and is considered as a natural response to the chronic irritation of bladder due to malignancy of the bladder.There is definite indication of spread of the disease in peri vesicular tissue .
As regards prostate being involved, it is difficult to make precise comments as these changes can be seen in chronic infection of prostate too..You will need to confirm or rule out the involvement of prostate by doing ultrasound guided multi core prostate biopsy.
Discuss the further management with your Uro Oncologist.
Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.
You do not have distant metastasis
Detailed Answer:
Hello
Thanks for posting PET/ CT report.
I have gone through the entire report and threads of our previous discussions .and noticed that it has not spread to distant organs or lymph nodes either locally or in para aortic lymph nodes.
Bladder shows changes of Cystitis Cystica which is a common feature and is considered as a natural response to the chronic irritation of bladder due to malignancy of the bladder.There is definite indication of spread of the disease in peri vesicular tissue .
As regards prostate being involved, it is difficult to make precise comments as these changes can be seen in chronic infection of prostate too..You will need to confirm or rule out the involvement of prostate by doing ultrasound guided multi core prostate biopsy.
Discuss the further management with your Uro Oncologist.
Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Before this PET/CT my urologist felt a bladder removal was the next step.
I am going to Mayo Clinic in XXXXXXX to see a Urologist on thursday.
I dont know what he will want to do.
What do you feel will be the next step?
Is the removal of the bladder the only option at this time?
I am going to Mayo Clinic in XXXXXXX to see a Urologist on thursday.
I dont know what he will want to do.
What do you feel will be the next step?
Is the removal of the bladder the only option at this time?
Brief Answer:
Radical Cystectomy is proper treatment .
Detailed Answer:
Hello
Thanks for follow up.
Considering the cancer being in a stage to infiltrate in peri Vesical tissue It is better to go for radical Cystectomy before it spreads further
Thanks and Regards.
Dr.Patil..
Radical Cystectomy is proper treatment .
Detailed Answer:
Hello
Thanks for follow up.
Considering the cancer being in a stage to infiltrate in peri Vesical tissue It is better to go for radical Cystectomy before it spreads further
Thanks and Regards.
Dr.Patil..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I understand that there are a number of different ways the cystectomy is done.
what is the best method?
The bag inside the body?
The bag outside the body?
What other?
what is the best method?
The bag inside the body?
The bag outside the body?
What other?
Brief Answer:
It is decided by the operating surgeon.
Detailed Answer:
Hello
Thanks for follow up.
In surgery of Radical Cystectomy entire bladder along with Prostate and surrounding lymph nodes are removed and a new bladder is created using either Ileum or Sigmoid colon as a reservoir which is anatomized to urethra so that one passes urine through normal urethra .So there in bag neither in body nor outside.the body.
It is the operating surgeon who decides the choice of either Ileal loop or Colon to be selected for to form a neo bladder.(Reservoir)
Thanks and Regards.
Dr.Patil.
It is decided by the operating surgeon.
Detailed Answer:
Hello
Thanks for follow up.
In surgery of Radical Cystectomy entire bladder along with Prostate and surrounding lymph nodes are removed and a new bladder is created using either Ileum or Sigmoid colon as a reservoir which is anatomized to urethra so that one passes urine through normal urethra .So there in bag neither in body nor outside.the body.
It is the operating surgeon who decides the choice of either Ileal loop or Colon to be selected for to form a neo bladder.(Reservoir)
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What is life after the operation like?
Would i have leakage?
Would i be impotent?
Would i have leakage?
Would i be impotent?
Brief Answer:
You will have good quality life.
Detailed Answer:
Hello
Thanks for follow up
The quality of life will be definitely better than what it would be after the cancer spreads to distant organs.
There will not be any leakage.
Since the surgery involves extensive dissection in pelvis it is very difficult to predict about the impotence .
Thanks and Regards.
Dr.Patil.
You will have good quality life.
Detailed Answer:
Hello
Thanks for follow up
The quality of life will be definitely better than what it would be after the cancer spreads to distant organs.
There will not be any leakage.
Since the surgery involves extensive dissection in pelvis it is very difficult to predict about the impotence .
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I went to Mayo Clinic today.
The suggested the removal of the bladder, prostate and some lympnodes.
This will be done on tuesday.
My options are a neo-bladder or a stoma with a bag.
I am trying to determine which way to go.
Can I Get some input.
The suggested the removal of the bladder, prostate and some lympnodes.
This will be done on tuesday.
My options are a neo-bladder or a stoma with a bag.
I am trying to determine which way to go.
Can I Get some input.
Brief Answer:
Neo bladder is good option.
Detailed Answer:
Hello
Thanks for follow up.
It is very difficult to manage stoma and you face to many complications as far as managing stoma like excoriation of surrounding skin ,smell of urine and need for repeated catheterization in a day is concerned .
Finally choice is yours.
Thanks and Regards.
Dr.Patil.
Neo bladder is good option.
Detailed Answer:
Hello
Thanks for follow up.
It is very difficult to manage stoma and you face to many complications as far as managing stoma like excoriation of surrounding skin ,smell of urine and need for repeated catheterization in a day is concerned .
Finally choice is yours.
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
i have a concern with the neo-bladder
the Dr. at mayo said the there is a chance
that i would have to use a catheter and i could have leakage
the Dr. at mayo said the there is a chance
that i would have to use a catheter and i could have leakage
Brief Answer:
Oncologist always give guarded opinion.
Detailed Answer:
Hello
Thanks for follow up.
I also give guarded opinion as far as choice and results of surgery are concerned because it is very difficult to predict the outcome of a such a major surgery and fewer complications are always there .But in a renowned institutions like Mayo clinic with Oncologist having vast expertise I think the results of the surgery are always commendable .
Any way all the best and wish you speedy recovery.
Thanks with regards
If you have time please post your review and rate my opinion and suggestions on the floor of XXXXXXX Care Magic.
Thanks and Regards.
Dr.Patil.
Oncologist always give guarded opinion.
Detailed Answer:
Hello
Thanks for follow up.
I also give guarded opinion as far as choice and results of surgery are concerned because it is very difficult to predict the outcome of a such a major surgery and fewer complications are always there .But in a renowned institutions like Mayo clinic with Oncologist having vast expertise I think the results of the surgery are always commendable .
Any way all the best and wish you speedy recovery.
Thanks with regards
If you have time please post your review and rate my opinion and suggestions on the floor of XXXXXXX Care Magic.
Thanks and Regards.
Dr.Patil.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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