Wk 4, Case 3 - Review

Please note: Items with dashed lines (--) are information withheld as it is not relevant for you to arrive at the correct findings and impression for the report and/or it was withheld for privacy information. The items were left in to show you the typical information documented in a PET report.

Clinical Indication:
Central left upper lobe endobronchial mass with pathology revealing low-grade neuroendocrine tumor, favoring carcinoid (typical). Evaluation for initial staging and treatment planning.

Technique:
Preparation: Not on Somatostatin Analogue Therapy.
Radiopharmaceutical: ------ mCi of Ga-68 dotatate (NETSPOT), a somatostatin analogue (SSA), administered intravenously at ------ at ---- PM
Incubation interval: ---- minutes.
Oral contrast: Not applicable.
Positioning: Arms by sides.
PET/CT scanner: ------.
PET/CT acquisition: Vertex-to-mid-thighs.
PET reconstruction method: Point Spread Function-Time of Flight (PSF-TOF), 2 iterations, 21 subsets, with and without CT-based attenuation correction.
Standardized uptake value (SUV): Corrected for ----.
CT: Low-dose, non-breath-hold, without intravenous contrast.
TOTAL DLP (Dose Length Product): ----- mGy cm.

Comparison/Correlation:
--

Findings:
Technical quality: Diagnostic.
Measurements: Unless otherwise specified, all SUVs refer to maximum value in the target.
Reference liver mean SUV -----


Head and Neck:
No suspicious DOTA-avid foci in the head or neck.
No suspicious DOTA-avid cervical adenopathy.
Paranasal sinuses are clear.
Thyroid gland is unremarkable.


Chest:
Intensely DOTA-avid central left upper lobe mass, difficult to accurately measure and differentiate from adjacent atelectatic lung on noncontrast CT images, maximum SUV 110.
Partial obstruction and atelectasis of the apicoposterior left upper lobe segment.
No additional DOTA-avid endobronchial or parenchymal masses.
No DOTA-avid or pathologically enlarged mediastinal or hilar lymph nodes.
No axillary adenopathy.
No pleural or pericardial effusion.
Normal caliber of the thoracic aorta. Normal heart size.


Abdomen and Pelvis:
No suspicious DOTA-avid foci in the abdomen or pelvis.
Solid Abdominal Organs:
No focal DOTA-avidity in the liver significantly greater than the heterogeneous physiologic uptake.
Unremarkable noncontrast appearance of the liver.
Cholelithiasis.
No hydronephrosis.
Unremarkable spleen.
No suspicious adrenal masses.
No suspicious pancreatic findings.
GI Tract/Mesentery/Peritoneum:
No suspicious DOTA-avidity in the gastrointestinal tract.
The large and small bowel appear normal in caliber.
No suspicious peritoneal/mesenteric findings.
Lymph Nodes: No pathologically enlarged or DOTA-avid lymph nodes.
Pelvic Viscera: Normal noncontrast appearance of the uterus and ovaries.
Dominant follicle in the right ovary.
Vasculature: Normal caliber of the abdominal aorta.
Free Fluid: No ascites or drainable fluid collection.


Skeleton and Soft Tissues:
No suspicious DOTA-avid foci in the visualized osseous structures.
No aggressive lytic or blastic osseous lesions.

Impression:
1. Intensely DOTA-avid central left upper lobe endobronchial mass consistent with biopsy proven typical lung carcinoid tumor, causing partial obstruction of the apicoposterior left upper lobe segment.
2. No suspicious DOTA-avid mediastinal or discrete hilar lymph node metastasis.
3. No evidence of DOTA-avid distant metastatic disease.