What to Expect From a PET/CT Scan
In March 2015, the results of an ultrasound and CT scan indicated that I had a large mass on my left kidney. After consultation with a urologist and surgeon in Bangkok, Thailand, I was advised to have surgery to remove the left kidney.
At the end of April 2015, my left kidney was removed and the mass on it found to be cancerous. No other cancer was found in my body, however, every six months since the operation, I have had full abdomen ultrasounds to check for recurrence of cancer in my abdomen. Fortunately, nothing had shown up from the ultrasounds and blood work which I have also had done.
On March 30, 2018, my urologist scheduled me for a PET/CT whole body scan to look for recurrence of cancer in my body.
In this article, I share my experience of what to expect from a PET scan, explain why doctors will order it, and relate the procedure to the results.
What Is a PET/CT Scan?
According to healthline.com, a PET scan (positron emission tomography) is one kind of imaging test that lets doctors look for diseases in your body. It uses a special dye fluorine-18 fluorodeoxyglucose (F-18-FDG) that has radioactive tracers. After the F-18-FDG is injected into a vein in your arm, organs and tissues in the body absorb the radioactive tracers. When they are highlighted under a scanner, the tracers help physicians determine how organs and tissues are functioning on a cellular level. The PET scan can measure blood flow, oxygen use, and glucose metabolism, and more. All cells need glucose or sugar, and cancerous cells, which use more glucose than healthy cells, attract more F-18-FDG. This will show up in the scan results.
A CT scan is another kind of imaging test that takes images of organs in the body using low doses of radiation. CT stands for computerized tomography.
Fused images of PET and CT scans are then reviewed by radiologists or nuclear medicine doctors.
Why Are PET/CT Scans Used by Doctors?
Doctors order PET scans to inspect blood flow, oxygen intake, and metabolism of organs and tissues. These scans can be used to detect cancer, heart problems, brain disorders, and problems with the central nervous system.
When the scan is used to detect cancer, it can evaluate whether cancer has recurred in the body. In detecting cancer, the PET scan allows doctors to see how cancer metabolizes, whether it has spread, or metastasized to new areas in the body. Information in this section is taken from healthline.com.
How Is the PET/CT Scan Conducted?
Prior to my PET/CT scan procedure, I had to answer a number of questions. They included whether I had hypertension, allergies to medicine, diabetes, or was claustrophobic. I was advised not to drink coffee or caffeinated soft drinks for one day prior to the procedure. Furthermore, I had to fast at least eight hours before the PET/CT scan but could drink only water.
On the scheduled day of the scan, I arrived at the hospital at least one hour before the scan. Upon arrival, I stripped down to my underpants and put on a hospital gown. After my blood pressure and weight were taken, 13.361 mci (millicuries) of F-18-FDG was injected into a vein in my left arm after blood was drawn.
Next, I was secluded in a private room on a hospital bed for one hour while the F-18 FDG worked its way throughout my body. Before laying down, I had to provide a urine sample for analysis.
Following one hour, I was taken to a big room which had a PET/CT scanner. First, I was instructed to lay down on a narrow bed which could be adjusted up and down outside of the PET/CT scanner with my head facing the scanner. Next, I had to grasp the back of my head with both hands and my arms close to my body.
About a minute later, the CT scan procedure began. As my bed passed slowly back and forth once through what looked like a big tube open on both sides, I had to take two deep breaths of at least 20 seconds in duration. This was repeated one more time.
Now it was time for the scan. My body was slowly moved through the tube stopping for five minutes at set intervals to have scans of various parts of my body. PET scans were conducted from my head to my feet. I had a loose strap around my waist and my head was restrained.
Toward the end of the 20-30 minute PET scan, I moved my body slightly due to the uncomfortable position I was in. There wasn't much clearance between my arms and the sides of the tube. Consequently, I had to spend an additional five minutes in the scanner getting my head rescanned.
My whole body scan was now finished. Before leaving the hospital, I was instructed to avoid contact with children and pregnant women. Radiation was in my body and would not be eliminated through my urine for eight hours. For this reason, I was told to drink a lot of water but had no other restrictions.
My PET/CT Scan Results
I finished my scan at around 10:00 am on a Friday morning but had to wait 24 hours for its results. Before meeting with my urologist and surgeon, Dr. Kittinut, at 3:00 pm on Saturday, I was quite anxious about the PET/CT scan results. Although I had felt fine physically, I was hoping and praying that nothing showed up on the scan.
Upon seeing Dr. Kittinut, he smiled and said he was very happy with the results of my scan. The doctor gave me a copy of the radiologist's scan report and stressed that there was no cancer detected in my body.
The findings from my PET/CT whole body scan are as follow:
Head and Neck
No enlarged cervical (neck) lymph node is detected. There is normal uptake (of F-18-FDG) within salivary glands, brain, and remaining cervical structures. The report noted that the PET/CT scan has limitations in the evaluation of small brain and meningeal lesions.
There is no abnormal uptake (of F-18-FDG) within the lungs. Physiologic myocardial uptake is present. There is no hypermetabolic pulmonary (lung) nodule or infiltration. There is no pleural or pericardial effusion (fluid around the lungs and heart.)
There is normal uptake within adrenal glands, liver, spleen, pancreas, right kidney, and collecting system. There is no abnormal hypermetabolic uptake at the left renal (kidney) surgery bed. I have right cortical renal (outer portion of the kidney) cysts. I also have a small accessory spleen in the left upper quadrant of my abdomen. Ten percent of people have accessory spleens usually measuring one centimeter. Mine was .7 centimeters. There were no hypermetabolic lymph nodes or enlarged lymph nodes detected. I have colonic diverticula but there is no evidence of acute diverticulitis (inflammation of pouches in the wall of the colon.)
There is a normal uptake in the prostate and seminal vesicles. I have an enlarged prostate gland, normal lymph nodes, and a normal bladder.
There are no metabolically active areas and no osteolytic or osteoblastic lesions (area of severe bone loss or increased bone production.)
Key Summary of PET/CT Whole Body Scan
1. There are no hypermetabolic lesions to suggest. There is no recurrent tumor, metastasis (development of secondary malignant growths from the original place of cancer,) or adenopathy (large or swollen lymph nodes.)
2. There are no hypermetabolic lesions in the left surgical bed and right kidney.
3. I have colonic diverticulosis (multiple pouches in the colon that are not inflamed.
4. I have BPH (benign prostatic hyperplasia- an enlarged prostate gland.)
Expected Financial Cost of a PET/CT Whole Body Scan
I learned that PET/CT full body scans are not cheap. The cost for my procedure at Bumrungrad Hospital in Bangkok was 72,000 Thai baht (about $2,325.) Bumrungrad is one of the top international hospitals in Thailand. The cost for a PET/CT scan is undoubtedly higher in the United States. Hopefully, my Blue Cross Blue Shield medical insurance will reimburse me for most of the cost.
Before undergoing a PET/CT scan, It is important to understand what it is and why it is used. I hope that my experience will help you understand how the scan is conducted and what results you can expect to see in a radiology report. Although PET/CT scans are expensive, they are important and almost essential for people like me who have had cancer and others who suspect that they have cancer.
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© 2018 Paul Richard Kuehn