Making sense of PET scan report
I'm hoping to get some help understanding the report from my PET scan I had last week. Unfortunately, I don'ts see my pulmonologist until a week from today and I would rather not spend the next 7 days with my mind wandering through every answer Dr. Google provides. I am a firm believer that worry only robs me of my joy today. But in this moment I'm struggling a little.
About 15 years ago we found a tumor on the right lobe of my lung. They had a hard time getting a biopsy because of where it was located. The ended up attempting a needle biopsy, but told me they couldn't actually get a biopsy because it kept "escaping" - They decided it was probably a hamartoma tumor because of the inability to puncture it. I was told to quit smoking (25+ year smoker) and we would keep an eye on it. I did quit that day.
Over the years the tumor would be seen on x-rays when I would have pneumonia or bronchitis. But I did not have any medical provider following it consistently.
Flash forward to 3 months ago, I had a nagging cough and a bit of trouble with breathing. Doctor tells me I have bronchitis and "by the way you have a spot on your lung that looks suspicious". CT scan ordered and a referral to the pulmonologist. Pulmonologist said the tumor looks concerning and that it had grown a bit since it was originally found. He says he does not think its a hamartoma and if I hadn't been a former smoker for 25+ years, he would probably wait and see a bit longer, but he wants me to get another CT in 3 months. About a week later, a friend reminds of the time I had my appendix removed and there was a small carcinoid tumor on the tip. I recall learning that carcinoid tumors are also frequently found in the lung. I provided that information to the pulmonologist and he sent me for a PET scan right away.
That was Friday. Today I got the report. This is what was at the conclusion of the report.
IMPRESSION:
1.7x 2.0 cm nodule which demonstrates moderate hypermetabolism with a peak SUV 2.6.
Moderate hypermetabolism is noted in the subcentimeter jugulodiagastric lymph nodes. Peak SUV measures 3.1 on the right and 3.2 on the left. No FDG avid lymphadenopathy is noted in the chest, abdomen or pelvis.
There are other details about Peak SUV measures for mediastinal blood pool (3.9) and Liver SUV (4.3). I have no idea what any of that means.
I would appreciate any insight anyone here might have. I understand that no one here can tell me a diagnosis, but I am hoping to learn more about what these details mean.
Thank you,
Jullie
Interested in more discussions like this? Go to the Lung Cancer Support Group.
Well you know I had VATS for left
Lower lobectomy. 3 smaller incisions. Not a walk in the park and I still feel like I have a vise grip on my rib cage when I try to breathe deeply. But all in all not terrible. And I’m 73.
Thanks for telling me that. I can't tell you how much it helps to know that someone else is in the same limbo and making it through. Actually my onc said to wait for 6 months until my next CT which at first I was afraid to wait that long - but he said if I get worried of course I can always schedule a scan in three months. I checked with my GP/PCP and he showed me all the scans again and we looked at the spot again. He agreed completely that I could wait for 6 months until next scan. He's just my GP but I feel so much better when I talk to him about these things too.
I've been thinking that I should use this 6 months to investigate a second opinion at a larger institution in preparation for the worst case situation in 6 months. I'm sure they could offer me a multitude of treatment options....but this 6 months off is time of peace and rest. Not sure if I want to dive into more doctor visits and worry.
Thank you. Tha t is a lot of good information. I see the pulmonologist tomorrow for his read on the PET scans.
Some questions I have:
I read that the SUV numbers on my report are PEAK SUV and not Max. Which, from what I can gather PEAK is qualitative and Max is quantitative. But what does that mean IDK
And the SUV for the nodes is like 3.2 and 3.4
But it says the liver SUV is 4.6 I am hoping that's because the liver is processing the radioactive medication they injected.
Most docs I believe just rely on SUV MAX. But if you want an activity that may cause your head to explode, well here is everything you never wanted to know on the topic of uptake values…
https://www.sciencedirect.com/topics/nursing-and-health-professions/peak-standardized-uptake-value
PET scans show hypermetabolic activity. Infection, inflammation, or cancer lights up.
@jcalkins, how did your appointment with the pulmonologist go? What did you learn? How are you doing?
You stated you had your third SBRT last October. Was each SBRT in different lobes?
@geraldkl, a belated welcome. Hi hip hooray for NED (no evidence of disease) after surgery. Did you have any other treatment besides surgery? What type of lung cancer did you have?
HI @lynn1961, welcome to Mayo Connect. Have you or a loved one been scheduled for SBRT? Do you have lung cancer?
Yes, I have stage one lung cancer and I start SBRT on Nov 1st.