Wk 4, 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:
-- years old with biopsy proven gastric GIST receiving chemotherapy.

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: --.
PET/CT scanner: ---.
PET/CT acquisition: Vertex-to-mid-thighs.
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:
--

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


Head and Neck:
No suspicious FDG avid lesions within the head and neck.
No suspicious FDG avid cervical lymphadenopathy.


Chest:
No suspicious FDG avid lesions within the chest.
No suspicious FDG avid lung nodules.
No suspicious FDG avid hilar or mediastinal lymphadenopathy.
No pleural effusion, pericardial effusion or pneumothorax.


Abdomen and Pelvis:
Exophytic intensely hypermetabolic necrotic gastric lesion measuring 74 mm with Maximum SUV 10.6.

Small sub-centimeter mildly hypermetabolic periportal lymph node, likely reactive.
Few subtle foci of FDG activity scattered throughout the liver just above the heterogeneous parenchymal uptake without definite corresponding lesions on the non-contrast CT images.
Multiple low-attenuation hepatic lesions, do not demonstrate focal FDG activity above liver parenchymal uptake level.

There is normal physiologic tracer activity in the spleen, pancreatic head, bilateral adrenal beds, collecting system of both kidneys, portions of ureters, urinary bladder and several segments of bowel.


Skeleton and Soft Tissues:
No suspicious FDG avid lesions within the soft tissues or osseous structures.
No aggressive lytic or sclerotic lesions.

Impression:
1. Exophytic intensely hypermetabolic necrotic gastric lesion, consistent with biopsy proven GIST.
2. No suspicious hypermetabolic or enlarged retroperitoneal adenopathy.
3. Few subtle foci of FDG activity scattered throughout the liver just above the heterogeneous parenchymal uptake without definite corresponding lesions on the non-contrast CT images. Further assessment with liver-protocol MRI recommended.
4. No convincing evidence of other sites of hypermetabolic distant metastatic disease.