Wk 2, 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.

Patient History:
--year-old female with history of progressive cervical lymphadenopathy has grown in size over 4 weeks prior to presentation to humeral clinic. Excisional cervical lymph node biopsy was performed showing mixed lymphocytic population which may be seen in Hodgkin lymphoma.

Technique:
Preparation: Last oral intake (except water)-------.
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 down.
PET/CT scanner: --------.
PET/CT acquisition: Vertex-to-feet.
Standardized uptake value (SUV): Corrected for -----.
TOTAL DLP (Dose Length Product): ----- mGy.cm.

Comparison/Correlation:
--

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

Head and Neck:
Multiple variable sized moderate to intensely hypermetabolic left lower cervical and bilateral supraclavicular lymph nodes with SUV max range of 3.9-5.2. For example:

left supraclavicular lymph node measuring 12 mm in short axis, maximum SUV 4.5.
No suspicious hypermetabolic intracranial FDG avid lesion.


Chest:
Multiple intensely hypermetabolic enlarged discrete and conglomerate superior mediastinal, left axillary and bilateral sub-pectoral lymph nodes with maximum SUV ranging from about 4 to 8. Examples are:

Left sub-pectoral/infraclavicular lymph node measuring 15 x 20 mm with maximum SUV 3.9
Anterior mediastinal mass measuring approximately 29 x 54 mm in maximal axial dimensions with maximum SUV 7.8
No suspicious FDG avid hilar lymph nodes.
No suspicious pulmonary nodules or masses.
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 non-contrast appearance of the liver.
Normal gallbladder.
No hydronephrosis.
No abnormal diffuse or focal FDG uptake in the 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.
Left ovarian cyst.
Benign-appearing linear activity along the left pelvic side wall which may be in the left ovary, fallopian tube, or decompressed loops of bowel.
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 significant increased bone marrow activity.
No aggressive osseous lesions.

Impression:
1. Hypermetabolic and enlarged left lower cervical, bilateral supra/infraclavicular, left axillary, and anterior mediastinal lymph nodes.
2. No evidence of hypermetabolic nodal disease below diaphragm.
3. No evidence of hypermetabolic extra-nodal disease.