Wk 1, 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:
--year-old female recently diagnosed with small cell lung cancer presenting for initial staging and treatment planning.

Technique:
Preparation: Last oral intake (except water) on ---.

Diabetic: No.

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-mid-thighs.
Standardized uptake value (SUV): Corrected for -----.
CT: Low-dose, non-breath-hold, without intravenous contrast.
TOTAL DLP (Dose Length Product): --- mGy cm.

Comparison/Correlation:
No comparison. No recent correlative imaging.

Findings:
Technical quality: ------.
Measurements: Unless otherwise specified, all SUVs refer to maximum value in the target.
Reference: mean SUV liver: --.
CT linear measurements performed on axial images.


Head and Neck:
No suspicious metabolically active lesions within the head and neck.
No suspicious metabolically active or pathologically enlarged adenopathy.
Unremarkable thyroid gland.


Chest:
Intensely hypermetabolic 16 x 13 mm anterior right upper lobe nodule maximum SUV 6.8, consistent with primary small cell lung cancer.
Moderately hypermetabolic nodular septal thickening radiating from the nodule likely representing peri-lymphatic spread.
Intensely hypermetabolic metastatic right hilar, pre-carinal and subcarinal adenopathy. Index nodes are:

22 x 19 mm right hilar lymph node maximum SUV 7
23 x 12 mm pre-carinal lymph node maximum SUV 7.2
Bilateral upper lobe predominant emphysematous changes.
Bibasilar atelectasis, apical, middle lobe and lingular scarring.
Aortic and coronary calcifications.
No pleural effusion, pericardial effusion or pneumothorax.


Abdomen and Pelvis:
No suspicious metabolically active lesions within the abdomen and pelvis.
No suspicious metabolically active or pathologically enlarged retroperitoneal or pelvic adenopathy.
Liver cirrhosis with splenomegaly stigmata of portal hypertension.
Unremarkable pancreas, kidneys and adrenals.
Calcified atherosclerotic changes.
Pelvic laxity/prolapse
No ascites.


Skeleton and Soft Tissues:
No suspicious metabolically active osseous or soft tissue lesions.
No aggressive lytic or sclerotic lesions.
Multilevel degenerative changes.
Left hip prosthesis.

Impression:
1. Intensely hypermetabolic right upper lobe nodule, consistent with primary small cell lung cancer, details above.
2. Intensely hypermetabolic metastatic right hilar, precarinal and subcarinal adenopathy.
3. No convincing evidence of metabolically active distant metastatic disease.