Pet Case Study Essay

Sentinel lymph node biopsy (SLNB) as an investigational tool in treatment of the clinical N0 neck aiming to prevent morbidity associ-ated with elective neck dissection, but up to date and our knowl-edge, there is no studies that have been reported on the use of SLNB in patients with laryngeal carcinoma.2

In order to properly stage the member for the second unexpected malignancy found after surgery, two viable options for staging existed. The first option, surgical staging, would mean a significant risk and increased morbidity for the member. The second option, a PET-CT scan, would be less costly and would be less morbid for the member. Therefore, the PET-CT scan was performed after careful deliberation at the facility in question and after consultation with outside cancer specialists. Thankfully, the PET-CT scan did not show evidence of residual

Researchers reviewed a total of 285 fourth and subsequent follow-up PET/CT. All the follow-up scans were performed within about 13 years of the original scans. The number of follow-up scans per patient ranged from 4 to 28 scans. Sixty-one (71.8%) patients had 4 to 6 follow up scans. Seventeen patients (20%) had 7 to 10 follow-up scans; 9 patients (10.6%) had more than 10 follow-up scans. A total of 112 scans were performed as the seventh follow-up scan or later. Of the 285 follow-up scans, 54 (48.2%) scans were performed for routine follow-up; 24 (21.4%) scans were done for posttreatment assessment of either chemotherapy, radiation therapy, surgical resection, or radiofrequency ablation instituted for disease recurrence; 7 (6.3%) scans were performed as part of mid chemotherapy response assessment; 14 (12.5%) scans were performed as follow-up of previously PET-positive findings; 9 (8%) scans were performed as follow-up of previously PET-indeterminate findings; 2 (1.8%) scans were performed for evaluation of a paraneoplastic syndrome; and 2 (1.8%) scans were performed for evaluation of clinically identified disease

Recent literature discusses the benefits of a dual PET/CT scanner in the workup of a SPN and as a staging tool for lung cancer. It combines the functional information provided by a PET scanner with anatomical structures acquired from CT (7). F-18-fluoro-deoxy-glucose (F-FDG) is the most commonly used PET tracer. It detects increased glucose uptake by rapidly dividing cancer cells. Malignant cells are known to have an increased number of glucose transporters and glycolytic enzymes, rendering them sensitive to FDG uptake (7). The CT is administered as a low dose, whole body scan, with or without contrast. FDG-PET/CT measures the standard uptake value (SUV) of the pulmonary nodule, which in turn measures glucose uptake (8).

The final diagnosis was acquired from both techniques were compared with other techniques (such as x-rays and MRI), with clinical follow up of patients, and with th e histological data of the

If the lymph nodes are not inflamed, a simple sentinel lymph node biopsy may be conducted. This procedure uses a radioactive substance injected into the cancer site and the doctor will remove any nodes marked with the radioactive substance. These nodes will be analyzed microscopically looking for cancer morphology. A needle biopsy is less invasive with the doctor simply injecting a needle into a swollen lymph node and collecting tissue and cells. This kind of biopsy does have the potential to miss signs of metastasis due to lack of

The following are some examples that are detected by this diagnostic tool: cancer, brain disorders, heart problems and problems in the central nervous system (Healthline, 2015). One of the brain disorders that PET can detect is Alzheimer’s disease. The patient would be advised not to eat or drink anything for 4-6 hours prior to the exam. The patient is injected with a dye called a radioisotope to demonstrate the function of a body part to rule out a diagnosis. Fluorodeoxyglucose (FDG) is the most common radioisotope used in PET. After the patient is injected, the radioisotope is absorbed by the tissues and organs (Dolson, L., 2001). When PET is used as a diagnostic tool for cancer, the clinician is then able to see how the malignant tumor is developing or if it has moved to other areas. It also allows the clinician to see how the malignancy is reacting to chemotherapy. PET scans show problems at the cellular level, therefore giving your clinician the best possible view of complex systemic diseases (Healthline, 2015). The tracers are normally out of the patient’s system within two days after a PET scan, but the patient should drink plenty of fluids afterward to help speed up the process of expelling the tracer.

Due to the various advancements of technologies in the field of radiography, sometimes it can be difficult to choose with imaging modality can be used to provided the best care for the patient and diagnose Clinicians must be aware of the potential benefits and drawbacks of each imaging modality to balance its use with healthcare costs, radiation dose to the patient, as well as patient safety.

Mediastinal tumors are best characterized by the compartment in which they originate. Malignant tumors of the anterior mediastinum are frequently due to lymphoma. Malignant tumors of the middle mediastinum are usually due to adenopathy from lymphoma or leukemia. Tumors of the posterior mediastinum are usually of neurogenic origin; with neuroblastoma being the most common (McCarville, 2010).

A lymphangiogram is a procedure to examine your lymphatic system. Your lymphatic system consists of lymph vessels and your lymph nodes. In this procedure, dye is injected through a long, thin tube (catheter). X-rays are then taken. The X-rays will show if there is a blockage or problem, such as a tumor.

Nuclear Medical Imaging (NMI) uses small amounts of radiopharmaceuticals or radiotracers to diagnose, evaluate and treat a variety of diseases such as cancer, heart disease, gastrointestinal, endocrine, neurological and skeletal disorders (McKinnis, 2014; RadiologyInfo.org (2014b). In comparison with other radiographic procedures, except for intravenous injections, NMI is noninvasive and diagnoses disease based on the physiological or functional changes of the tissue, organ, bone or system within the body rather than structural changes of anatomy (McKinnis, 2014; RadiologyInfo.org, 2014b; Smith, n.d.). These radiotracers are either injected, ingested or inhaled as a gas into the body and absorbed by the organ or area of the body to be examined

Based on the score sheet developed by the researcher (Appendix 3), the result were demonstrated in figure 4.9., all PET/CT departments participant in the survey their concern were to provide the patient with sufficient information about PET/CT procedure in first place with an average (mean = 56%), followed by clarifying patient basic details

Um SW, Kim HK, Jung SH, et al. Endobronchial ultrasound versus mediastinoscopy for mediastinal nodal staging of non-small-cell lung cancer. Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. 2015;10(2):331 - 7.

In the same way, the images in the PET scan are not as clear as with the CT scans and MRI, so sometimes localizing the exact place of the increased activity can be a problem 2) it takes more training to learn to read them well 3) since inflammation shows as "hot" on a PET scan, if there is a lot of inflammation present it can obscure other activity on the scan and 4) it tends to work better for higher grade tumors and metastasis, as well-differentiated tumors have less metabolic activity (they are usually growing more slowly).

In addition to its physiologic accumulation in different organs, it can accumulate in non-neoplastic pathologic conditions, including infection, whether acute or chronic infection such as tuberculosis, granulomatous diseases such as sarcoidosis , and autoimmune disease such as Grave’s disease. In addition, the 18F-FDG uptake can be enhanced by inflammatory induced changes, which include post-operative healing scars and post-radiation therapy. A unique example of an inflammatory condition is the one caused by the atherosclerotic plaque formation that is associated with an abundance of macrophages known by its avidity to 18F-FDG. The degree of uptake is usually less than the uptake within the neoplastic tissues. However, there is clearly an overlap between the 2 conditions and, in some cases; the uptake could even exceed the neoplastic uptake. Furthermore; the image interpreter should be aware of a high accumulation of 18F-FDG in some benign tumors, such as giant cell tumor, fibrous dysplasia of the bone, and adenomatous polyps in the colon. Occasionally one will also see breast-related activity. Breast activity will be more obvious in lactating females (Abouzeid et al,