How to interpret recent PET scan results

For me personally, I would interpret that as the tumor is still active, but because SUV increased very little, it's not considered a significant change. Perhaps since it's been 3 months of chemo and tumor still very active, your oncologist may consider switching chemo regimens. I'm not sure how many rounds they wanna do before expecting a response.

I didn't have PET at that point in time. But after 2 rounds my CA19 increased a lot and CT showed tumor growth, so I switched to Gem/Abrax.

Hopefully we can get some more input here from the group. I was diagnosed in March of 2023 and had the Whipple in June. Just had my first PET/CT scan this week and have not had a chance to review with my oncologist yet. From what I've read, both the 6.9 and 7.2 SUV readings are in the moderate range. Similar to the CA19, they seem to focus on "direction" of the readings. As @ashley2235 said, they may look at your mix for the chemo you are currently doing. I had a SUV 7.5 on my spine, that they did radiation for these past 2 weeks. If you only had the one spot from the PET scan you "might" want to just ask your oncologist if radiation could be of any help in your situation. Unfortunately for me, the radiologist said that the PET scan showed both a couple of lymph nodes and the liver with numerous points ( 7+) that "Lite up" on the PET scan picture. I start my Gem/Abrax (3 on , 1 off) in March to see if that will help with all the other areas. Definitely have all your specific questions ready for when you see your oncologist. Please let us know what he thinks about your SUV going up slightly. thank you.

https://cancerimagingjournal.biomedcentral.com/articles/10.1186/s40644-016-0091-3
Hello @steveron
Above is a link to search question about how to read PET scan interpretations. It’s full of technical data I skipped through but the bottom line is FDG is a radiotracer that is not considered as invasive as other tests, though it is typically used in conjunction with a CT as in my case. FDG is glucose that gets trapped in cells and since cancer cells divide very quickly they use high amounts of glucose and this should be seen on your PET scan as FDG avid. However, I was told by radiologist that FDG uptake can also be seen in areas of inflammation that are not cancerous. Also, not all types of cancer will show FDG uptake as in my case where I had a soft tissue area light up on my CT around the celiac/hepatic arteries thus prompting my drs to say it was scar tissue. If I was the oncologist I would have followed up with a biopsy of that area instead of the assumption it was scar tissue. That assumption led me into stage 4. As Ashley2235 very well indicated, there is some uptake of the glucose and it has grown in size when compared to your last PET scan. I had removal of 75% of my pancreas (distal or tail) and chemo with Fulfirnox. Surgery was good, no recurrence at the site, however due to complications from the surgery I had to wait a month longer than typical to begin my post surgery chemotherapy. During that extra month is when my cancer spread to the hepatic celiac arteries. It was kept at bay during my 12 treatments, but 4 months after chemo was completed, it spread to my liver and other areas. I getting chemo again with the GAC chemo which I’m responding to though it’s playing havoc with my “fighter” cells. 3 mos chemo is still early in the process; however there are other chemo options and possibly radiation? Best of good will to you. We are all rooting for you!

Quick question(s) marienewland:

So you have been on GAC for the past 3 months ? How did they decide to add the C ?

How often do they do a CA19 test? CT? how long before you were able to see the chemo was helping?

Have you had a base PET/CT and are they testing you again to see the effectiveness of the GAC?

How well are you tolerating the GAC? Fatigue, nausea, stomach pain?

thank you so much for your feedback and the PET link 🙂

Walter

No actually I was referring to the poster who said they had chemo for 3 months. I started in January. Each drug in the chemo combos have their targets, but I believe it’s the platins (oxy for Folfirnox and cis for GAC) that is the most potent one in the group. Platins also can lead to neuropathy, though. I had a little neuropathy from my Folfirnox treatments which ended in June of 2023, but after a couple of months I experienced no neuropathy at all. Also, I have a very aggressive cancer my new oncologist tells me so it makes sense to attack with everything they’ve got which includes the cis particularly since the potential for neuropathy side effect for me is low. I’m on the more aggressive one right now which is 3 weeks on and 1 week off. Eventually, God willing, I’ll be able to taper off to the typical maintenance dose of every 2 weeks.

Sorry, Waltersocal I originally read your question in my email and didn’t see there were additional comments.
Again, from what I’ve been reading on connect.mayoclinic, it appears to me that results are based on the type of mutation you have. I have the KRAS12-D, ATM base 40 variant, TP53 and TSC2? mutations. It’s a lot. I saw my CA19-9 decrease in this order from 3840 to 2710 to 550 this is basically the 3:1 schedule of chemo, but I caught covid in January so after first treatment I had to wait a week or 2 before I could get a 2nd treatment. I get ca19-9 2x per month. I’m fine with that. My next CT will be early March. I had the works (MRI, PET, CT,EUS) between November and December of last year. The nausea is very bad right now though a patch the dr recommended helped a bit. I get my chemotherapy on Thursdays and then by Saturday and Sunday I’m pretty much trying to sleep it off; better Monday and then each day better until the cycle repeats itself. I work part time and am on an Environmental board and we just sold our home, so as you can I’m as imagine I’m pretty busy in addition to relatives and friends coming to visit. Just have to have things to do to keep your mind off the stuff going on. No weight loss though!

@steveron, have you had a chance to talk with your oncologist in the meantime about the results of your PET scan? What did you learn? How are you doing?