Wk 2, Case 5 - 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 with right frontal scalp lesion. Biopsy positive for T3b melanoma. Presenting for initial staging and 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 by sides for whole body scan and neck scan
PET/CT scanner: -------.
PET/CT acquisition: Vertex-to-feet, plus magnification (zoomed) neck.
Standardized uptake value (SUV): Corrected for ----.
CT: Low-dose, non-breath-hold, without intravenous contrast.
TOTAL DLP (Dose Length Product): ----- mGy.cm.

Comparison/Correlation:
None.

Findings:
Technical quality: Diagnostic.
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:
Intensely hypermetabolic soft tissue lesion measuring 1.2 x 1.7 cm arising from the right frontal scalp with max SUV of 8.4.
An enlarged moderately hypermetabolic right level IIB cervical lymph node measuring 1.1 cm in short axis with max SUV of 4.1.
Non-FDG avid, hypodense nodule within the right thyroid lobe measuring 1.1 cm.


Chest:
No suspicious hypermetabolic foci within the chest.
Right lower lobe granuloma.
No suspicious lung nodules.
No suspicious mediastinal or hilar adenopathy.
Right chest wall AICD with leads terminating in the right atrium and right ventricle.
Coronary artery calcifications. Aortic atherosclerosis.


Abdomen and Pelvis:
No suspicious hypermetabolic foci within the abdomen or pelvis.
No suspicious hypermetabolic retroperitoneal or pelvic adenopathy.
Distended gallbladder with cholelithiasis.
The liver, adrenal glands, and kidneys are normal in appearance.
No hydronephrosis.
Normal sized spleen with scattered granulomata.
Diffuse colonic diverticulosis.
No bowel wall thickening.
No pneumoperitoneum.
Uterus is absent.


Skeleton and Soft Tissues:
No suspicious hypermetabolic foci within the osseous structures or soft tissues.
No aggressive lytic or sclerotic lesions.
Levocurvature of the lumbar spine.
Degenerative changes throughout the spine. Old, healed left superior pubic ramus fracture.

Impression:
1. Intensely hypermetabolic soft tissue lesion arising from the right frontal scalp consistent with biopsy-proven melanoma.
2. Intensely hypermetabolic metastatic right level IIB cervical lymph node.
3. No evidence of hypermetabolic distant metastatic disease.
4. Non-FDG avid hypodense nodule in the right thyroid lobe can be further evaluated with thyroid ultrasound.