EXAM: PETCT LIMITED WHOLE BODY VERTEX TO MID THIGH
CLINICAL HISTORY: 73 years old Male with history of colon cancer status post right colectomy for staging. No prior PETs available for review.
REASON FOR THE STUDY: Staging.
TECHNIQUE: Patient's fasting time was > 6 hours. Following intravenous administration of 7.5 mCi of F18-FDG, CT was acquired from vertex to mid thighs with intravenous contrast (149 mL of Omnipaque 350). This was followed by an emission PET scan started 85 minutes after FDG injection. PET images were corrected for attenuation using the CT transmission data. A rotating 3D MIP, as well as axial, coronal, and sagittal PET images with and without attenuation correction was interpreted. Acquired and fused PET/CT images were reviewed alongside the PET images. Patient's random blood glucose at the time of FDG injection was 97 mg/dL.
RADIATION DOSE INDICATORS:
[Patient] received 1 exposure event(s) (excluding scout) during this CT study. The CTDIvol (mGy) and DLP (mGy-cm) radiation dose values for each event are:
Event: 1; anatomic area: Abdomen; phantom: body; CTDIvol: 6.3; DLP: 717.6
The dose indicators for CT are the volume Computed Tomography Dose Index (CTDIvol) and the Dose Length Product (DLP), and are measured in units of mGy and mGy-cm, respectively. These indicators are not patient dose, but values generated from the CT scanner acquisition factors. Individual patient doses calculated from these values will depend on patient size and can substantially underestimate or overestimate the actual dose. For additional information on radiation dose, safety, and protection in the UCSF Department of Radiology and Biomedical Imaging, please refer to one of our FAQ leaflets on "Computed Tomography (CT)" or go to http://www.radiology.ucsf.edu/patients/radiation.
FINDINGS:
Brain: unremarkable, symmetric, FDG uptake is seen throughout the cortical gray matter, basal ganglia and the cerebellum. No mass effect. While these images appear within normal limits, MRI is recommended to rule out intracranial and/or skull base metastases if clinically indicated.
Incidentally noted is symmetric decreased metabolic activity involving bilateral parietotemporal lobes which is nonspecific and may be technically related, however this distribution can be seen in the setting of Alzheimer's disease.
Neck: No hypermetabolic neck masses or lymphadenopathy.
Chest: No hypermetabolic lymphadenopathy. Two tiny 2 mm pulmonary nodules peripherally in the right lower lobe. Inferior segment of the left upper lobe there is a 2 mm pulmonary nodule with suggestion internal calcification.
Abdomen/Pelvis: No hypermetabolic lymphadenopathy.
Status post right colectomy and postoperative changes at the hepatic flexure.
Multiple stable hepatic hypodense lesions are again identified some of which are too small to characterize. Stable oval 2.4 cm right adrenal nodule with slight FDG activity corresponding to an adenoma.
The remainder of the abdominal/pelvic organs are unremarkable.
Musculoskeletal: No metastatic disease. Status post left hip hemiarthroplasty with mild FDG activity at the inferior tip of the hardware in the mid left femur likely related to reactivated marrow.
IMPRESSION:
1. No recurrent or metastatic disease.
2. Tiny nonspecific pulmonary nodules in the right lower and left upper lobes. Attention on followup.
END OF IMPRESSION.