Wk 5, Case 2 - 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 male presenting for evaluation of vagal paraganglioma.

Technique:
Preparation: --- Somatostatin Analogue Therapy.
Radiopharmaceutical: --- mCi of ---- dotatate (DETECTNET), a somatostatin analogue (SSA), administered IV at ---- at ---.
Incubation interval: ---minutes.
Oral contrast: ---.
Positioning: ---.
PET/CT scanner: -----.
PET/CT acquisition: Vertex-to-mid-thighs.
Standardized uptake value (SUV): Corrected for body weight only.
CT: Non-breath-hold, without intravenous contrast.
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.
Reference: mean SUV liver: --.
CT linear measurements performed on axial images.


Head and Neck:
Hypodensity of the anterior limb of the right internal capsule and right corona radiata without associated SSA avidity, likely vascular insult.
Intensely SSA-avid soft tissue fullness within the right parapharyngeal region slightly inferior to the right fossa of Rosenmuller.
No additional foci of suspicious SSA avidity in the head and neck.
Unremarkable thyroid.


Chest:
No suspicious SSA-avid lesions in the chest.
Bilateral apical and middle lobe scarring.
There is upper lobe predominant emphysema.
No suspicious pulmonary nodules or is limited due to low-dose study technique.
Sequelae of prior granulomatous insult.


Abdomen and Pelvis:
No suspicious SSA-avid lesions within the abdomen and pelvis.
There may be mildly prominent SSA avidity associated with the distal esophagus where there appears to be a small hiatal hernia, likely reflux disease.
Unremarkable liver, spleen, adrenal glands and pancreas.
No suspicious retroperitoneal, pelvic or inguinal lymphadenopathy.
No ascites.
Ectasia of the distal infrarenal abdominal aorta, measuring up to 3.0 cm.
Calcified atherosclerotic changes.


Skeleton and Soft Tissues:
No SSA avid osseous or soft tissue lesions.
No aggressive lytic or sclerotic lesions.
No thoracolumbar compression fractures.

Impression:
1. Intensely SSA avid right parapharyngeal soft tissue lesion, likely representing the known vagal paraganglioma.
2. No suspicious SSA-avid or enlarged cervical adenopathy.
3. No convincing evidence of SSA-avid regional or distant metastatic disease.