Wk 1, Case 1 - 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:
Weight loss, unintended. Progressive cognitive decline, diplopia, lack of sleep, and possible seizures. Low NMDAR titers in CSF per the electronic medical record. Evaluation for treatment planning.

Technique:
Preparation: Last oral intake (except water) on --at --.
Diabetic: --.
Blood glucose at time of FDG administration: --- mg/dL.
Radiopharmaceutical: -- mCi of F-18 FDG administered IV at -- at --.
Incubation interval: -- minutes.
Oral contrast: --.
Positioning: Arms raised
PET/CT scanner: ---.
PET/CT acquisition: Vertex-to-midthigh.
PET reconstruction method: ---
Standardized uptake value (SUV): Corrected for body weight only.
CT: Low-dose, non-breath-hold, without intravenous contrast.
TOTAL DLP (Dose Length Product): -- mGy cm.

Comparison/Correlation:
No relevant prior imaging for comparison

Findings:
Technical quality: Diagnostic.
Measurements: Unless otherwise specified, all SUVs refer to maximum value in the target and all CT linear measurements are performed on axial images.

Reference: mean SUV liver: ----


Head and Neck:
No suspicious hypermetabolic activity in the head or neck.
Specifically, no suspicious focal sites of increased or decreased metabolic activity in the brain, significantly different from background.
No pathologically enlarged or hypermetabolic cervical lymph nodes.
No abnormal thyroid activity.
Brown fat activity.


Chest:
No suspicious hypermetabolic activity in the chest. Bilateral supraclavicular axillary and superior mediastinal brown fat activity.
No suspicious pulmonary nodules or masses. No focal consolidation.
No hypermetabolic mediastinal, hilar, or axillary adenopathy. No pleural or pericardial effusion. No abnormal esophageal activity.
Normal caliber of the thoracic aorta.


Abdomen and Pelvis:
No suspicious hypermetabolic activity in the abdomen or pelvis.
Solid Abdominal Organs: No focal hypermetabolic activity in the liver significantly greater than the heterogeneous physiologic uptake. Unremarkable noncontrast appearance of the liver. Normal gallbladder. No hydronephrosis. Unremarkable spleen. No suspicious adrenal masses. No suspicious pancreatic findings.
GI Tract/Mesentery/Peritoneum: Physiologic bowel activity, without suspicious focal FDG uptake. The large and small bowel appear normal in caliber. No suspicious peritoneal/mesenteric findings.
Lymph Nodes: No pathologically enlarged or hypermetabolic lymph nodes in the abdomen or pelvis.
Pelvic Viscera: Unremarkable prostate gland. Distended urinary bladder.
Vasculature: Normal caliber of the abdominal aorta.
Free Fluid: No ascites or drainable fluid collection.


Skeleton and Soft Tissues:
No suspicious hypermetabolic activity in the visualized osseous structures.
No aggressive osseous lesions.
No suspicious soft tissue foci.
Diffuse heterogenous FDG activity localizing to fat within bilateral neck, supraclavicular, suprasternal, mediastinal, axillary, and medial intercostal region, in a pattern suggestive of physiologic brown fat activation.

Impression:
1. No evidence of FDG-avid primary or metastatic disease.