PET scan result

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sulthana
Posts: 16
Joined: Mon Mar 26, 2012 9:53 am
Location: India

PET scan result

Postby sulthana » Thu Jul 18, 2013 8:35 am

My mom's PET scan came today.It states ,"Hypermetabolic uptake noted at anastomatic site with no significant CT abnormality,SUV max of 5.5".The rest of the body including liver ,lungs are normal.
Is this a sign for local recurrence?
I am taking my mom to doctor this week.I am really worried about this.
How come PET shows activity while CT is normal?Could this be a false positive?The report says may be an early sign of recurrence.
DD of Mother-52 years Dx'd with cc,
t3N2aM0 cc, stage IIIB,
4/12 LN's,
Dx'd-nov/11,
surgery-nov/11,
folfox 6 regime completed
colonscopy normal july/12
CT normal july/12

SoConfused
Posts: 1024
Joined: Mon Jan 30, 2012 2:40 pm

Re: PET scan result

Postby SoConfused » Thu Jul 18, 2013 9:01 am

sulthana wrote: with no significant CT abnormality,SUV max of 5.5".


I am not a doctor ... but this certainly does not sound like a recurrence if there is no corresponding abnormality on the CT. How long ago was your mother's surgery? perhaps what's lighting up is a result of surgical changes.
Stage IV CC

sulthana
Posts: 16
Joined: Mon Mar 26, 2012 9:53 am
Location: India

Re: PET scan result

Postby sulthana » Thu Jul 18, 2013 9:47 am

The surgery happened in nov 2011.Just thinking, whether it could be inflammation or some other reason.
DD of Mother-52 years Dx'd with cc,
t3N2aM0 cc, stage IIIB,
4/12 LN's,
Dx'd-nov/11,
surgery-nov/11,
folfox 6 regime completed
colonscopy normal july/12
CT normal july/12

mtlimpactfan
Posts: 96
Joined: Fri Dec 28, 2012 2:02 pm
Location: Montréal Quebec

Re: PET scan result

Postby mtlimpactfan » Thu Jul 18, 2013 9:53 am

Hi Sulthana,
my DW is more or less in the same situation where her latest PET scan showed a tiny area with a 4.7 SUV ratio. The next step is the MRI that will give extra clues on any thickening of tissus in the concerned area and a biopsy will most probably sort out the whole situation. It could be some sort of inflammation if surgery was recent or an infection, so I think that you should investigate a bit more. Keep us posted!
DW 38 DX 1/09 CRC(T3N1) 3/33 LN (colitis @19yo)
6/09 Temp Ileo J-pouch
Folfox 12 rds
06/12 regional recurrence SRC adn poorly diff Gr3/3
28rds ChemRad
surgery (hyst, ileo)
12/12 Folfox 12 rds
2013 All neg Pet/CT
05/14 It's back, inoperable
09/14 Vectibix

Ehut
Posts: 175
Joined: Wed Sep 26, 2012 4:24 pm
Location: Algonquin, IL

Re: PET scan result

Postby Ehut » Thu Jul 18, 2013 10:39 am

I had the reverse case a few months ago, where the CT showed some ill defined tissue behind the anastomosis, so my surgeon recommended a PET/CT which showed almost no uptake so he wasn't concerned anymore. I suspect a biopsy will be the next step for you.
Dx 12/11 rectal stage IV w/ 6 mets to liver
4 cycles FOLFOX 12/11 to 2/12
5 days radiation 2/12 (European protocol)
rectal/liver resection 3/12, temp ileostomy
8 cycles FOLFOX/FOLFIRI 4/12 to 8/12
ileostomy reversal 10/12
port out 10/13
NED for 6+ years and counting!

Asterix
Posts: 333
Joined: Wed Sep 26, 2012 1:51 am
Location: Brisbane, Australia

Re: PET scan result

Postby Asterix » Thu Jul 18, 2013 5:46 pm

I have had 3 PET/CT. at diagnosis Nov 2011 (but just after colon resection), Mar 2012 and Apr 2013. The first one showed some distant lymph node mets and uptake at the anastomosis. Lymph nodes went away after chemo, but the anastomosis site still lit up - once was concerned. The last PET in Apr showed the lymph nodes back (CEA had gone up - lymph nodes have now been resected) but my anastomosis still lit up. Report said concern for local recurrence and recommended investigation - ie colonoscopy. I had a scope in Dec 2012 with some polyps removed, but the anastomosis was fine. My onc said the anastomosis can continue to light up for some time post op, but as long as a colonscopy is clear then it should be fine.
Stage IVb age 37 Nov11
FOLFOX+Avastin, Xeloda+Avastin
1 year NED
regorafenib Oct13-Feb14
lymph node, lung, spine, rib and liver mets
GNAQ Q209P mutation > Mekinist Jul14
Radiation bone mets Aug14
Pain>hospital Oct14
FOLFIRI Nov14 >
Home Xmas 14

SoConfused
Posts: 1024
Joined: Mon Jan 30, 2012 2:40 pm

Re: PET scan result

Postby SoConfused » Mon Apr 16, 2018 7:30 pm

Ehut wrote:I had the reverse case a few months ago, where the CT showed some ill defined tissue behind the anastomosis, so my surgeon recommended a PET/CT which showed almost no uptake so he wasn't concerned anymore. I suspect a biopsy will be the next step for you.



Hi everyone - it has been a long while since I have posted anything here ... admitedly, it was nice pretending like I had returned to a “normal” life where cancer was no longer a possibility ... well, today I have been reminded that once you have entered this world (cancer), there is really no leaving it behind.

My routine contrast enhanced CT scans today have revealed a new 13mm nodular density along the posterior margin of the anastomatic suture (sigmoid) that is concerning for recurrence.
My original colon resection surgery was in June 2011 ... no local recurrences since then.

The radiologist has recommended a PET or Colonoscopy as a next step. I am scheduled to see my oncologist next Tuesday ... was hoping for a routine check-in, but we shall see.

Meanwhile, I am wondering if anyone here has had a similar experience ao far out from original surgery ... and if regardless of the timing, what if any other possibilities have come up other than a recurrence.

Just need to know if there are other things this could be ...

Many thanks,
SoConfused
Stage IV CC

Ehut
Posts: 175
Joined: Wed Sep 26, 2012 4:24 pm
Location: Algonquin, IL

Re: PET scan result

Postby Ehut » Thu Apr 19, 2018 10:09 am

Hello SoConfused,

So sorry to hear that you are dealing with a possible recurrence, especially so far out from the original diagnosis. I was diagnosed in 2011, so it is a bit jolting to see that recurrence is still possible when things are going well for so long. Hopefully your situation turns out to be benign so you don't have to go through the rodeo again.

In my case, the CT scan was performed at a local hospital, and the area of concern wasn't really flagged as concerning by the radiologist. I had the CT sent to my surgeon at Mayo Clinic, and he was a bit more concerned about the "ill defined" area behind the anastamosis, so he suggested I get a PET/CT scan. The area in question did not light up on the scan, so it was deemed to be "post operative changes", which I think is just code speak for scar tissue and connective tissue that forms in a void after surgery. This area was spotted about a year after my surgery, so that would be around March of 2013. At the time, the surgeon had said that if it turned out to be malignant, that he would perform an abdominoperineal resection (APR), which would have left me with no rectum and a permanent colostomy.

Have you had radiation to the affected area? I had a "short course" of radiation to the rectum the week before surgery. They said that would roughly halve the probability of recurrence in that area (from 20% to 10%).

I hope you have a good outcome, preferably without any treatment needed. Feel free to ask me if you have any more questions.
Dx 12/11 rectal stage IV w/ 6 mets to liver
4 cycles FOLFOX 12/11 to 2/12
5 days radiation 2/12 (European protocol)
rectal/liver resection 3/12, temp ileostomy
8 cycles FOLFOX/FOLFIRI 4/12 to 8/12
ileostomy reversal 10/12
port out 10/13
NED for 6+ years and counting!

SoConfused
Posts: 1024
Joined: Mon Jan 30, 2012 2:40 pm

Re: PET scan result

Postby SoConfused » Sun Apr 22, 2018 10:55 am

Ehut wrote:Hello SoConfused,

So sorry to hear that you are dealing with a possible recurrence, especially so far out from the original diagnosis. I was diagnosed in 2011, so it is a bit jolting to see that recurrence is still possible when things are going well for so long. Hopefully your situation turns out to be benign so you don't have to go through the rodeo again.

In my case, the CT scan was performed at a local hospital, and the area of concern wasn't really flagged as concerning by the radiologist. I had the CT sent to my surgeon at Mayo Clinic, and he was a bit more concerned about the "ill defined" area behind the anastamosis, so he suggested I get a PET/CT scan. The area in question did not light up on the scan, so it was deemed to be "post operative changes", which I think is just code speak for scar tissue and connective tissue that forms in a void after surgery. This area was spotted about a year after my surgery, so that would be around March of 2013. At the time, the surgeon had said that if it turned out to be malignant, that he would perform an abdominoperineal resection (APR), which would have left me with no rectum and a permanent colostomy.

Have you had radiation to the affected area? I had a "short course" of radiation to the rectum the week before surgery. They said that would roughly halve the probability of recurrence in that area (from 20% to 10%).

I hope you have a good outcome, preferably without any treatment needed. Feel free to ask me if you have any more questions.


Hi Ehut, thanks so much for responding and sharing your experience. I am scheduled for a colonoscopy next Thursday .... my oncologist and surgeon preferred this over a PET scan. I also felt more comfortable with this approach. Until then, I am sure my mind will continue to wander around the possibilities ... all I can do right now is pray.

Wishing you smooth sailing and many many more years of NED.
Stage IV CC


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