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smallest tumors that turned up on your PET, PET/CT or PET/MRI ??

Posted: Mon Feb 11, 2019 8:16 am
by Nordy1
Hi everyone
I posted on another place here but I dont think my question was clear. Im hoping for people in similar situations to tell me there stories of what was next in terms of testing. If CT scans and ultrasound are inconclusive what did/does your dx do for small indeterminate lesions? I have another CT scan tomorrow and if they once again dont offer any clarity ( Onc on the fence about what they are) what should I ask for? My onc thinks they are too small for PET scan - largest 1.1 or 1.2 cm, sthen 4, 6 and 8 mm.
take care,
Nordy

My earlier post:

When I was first diagnosed with cancer on my colon last year it was noted that I had indeterminate nodes on my liver, lungs and kidney, all smaller - largest being 1.2 cm. I was under the impression that they would be watched for 3 things - growth (potential cancer) shrinkage (potential cancer responding to chemo) or stagnant (potential scarring). Non of these were concrete but loose rule of thumb to watch for as infection was another possibility. On my second scan the nodes had disappeared and there was/is a big question of "were they or weren't they" mets. I was sent to ultrasound on Monday for a different look and low and behold the nodes are all still there. The ultrasound has not been able to clarify anything except they show bigger butt that could apparently be differences in measuring between ultrasound and CT scan. So now I'm back on Tuesday for a 3rd CT scan for yet another look. If that doesn't tell the story then I'm really not sure what the next step usually is or what I should ask for. If they are indeed mets then early intervention is supposed to be key which makes me uncomfortable with the "lets just wait for them to do something" approach. On the other hand I dont know anything....:(

I have learned that when nodes are under 1 cm they can seem to disappear but just not be visible in that particular scan but it sure doesn't help you feel confident in the process of scanning..

Any input from others on what the next step usually is from your experience?

Re: smallest tumors that turned up on your PET, PET/CT or PET/MRI ??

Posted: Mon Feb 11, 2019 9:22 am
by martd
Have they mentioned doing a biopsy? I believe it's an easy procedure, they use a needle. My onc mentioned biopsying my liver mets at my first appt. but he never did saying it wasn't necessary.

Re: smallest tumors that turned up on your PET, PET/CT or PET/MRI ??

Posted: Mon Feb 11, 2019 10:31 am
by Nordy1
Hi martd
Another Onc at the clinic mentioned biopsy in passing but I forgot to ask my own onc about it. I hesitate a bit there because of the chance of needle track seeding should it actually be cancerous, but of course if there is no imaging techniques that can answer then that is probably the next step.

thank you for answering
Nordy

Re: smallest tumors that turned up on your PET, PET/CT or PET/MRI ??

Posted: Mon Feb 11, 2019 11:08 am
by LPL
On my husband’s PET scan they could see 2 nodules in his lung. They were noted as 8mm and 11mm on the CTscan a week earlier.

Re: smallest tumors that turned up on your PET, PET/CT or PET/MRI ??

Posted: Mon Feb 11, 2019 2:43 pm
by susie0915
I had a 4mm nodule show up on a scan 2 years ago. My oncologist and pulmonologist both said too small for pet scan to pick up or to biopsy. Pulmonologist said it would have to at least double in size. I had 3 repeat scan within the following year with no change in size. The last scan in May, the radiologist attributed it to fibrosis as I have been monitored for lung scarring and inflammation that appeared after chemotherapy. I will have a scan in April which will be a year from the last, and hopefully it will have not changed or maybe even shrunk or disappeared.

Re: smallest tumors that turned up on your PET, PET/CT or PET/MRI ??

Posted: Mon Feb 11, 2019 3:45 pm
by stu
Hi ,
My mum had uptake on a 7 mm lung met with a PET scan . Removed by VATs and confirmed to be a met .
Hope you get answers soon .
Stu

Re: smallest tumors that turned up on your PET, PET/CT or PET/MRI ??

Posted: Mon Feb 11, 2019 4:37 pm
by betsydoglover
The size you mention can definitely be detected on PET by a good radiologist. My lung nodule was 9x11mm - uptake only 1.0 on PET, but my wonderful radiologist could see that it was ever so slightly brighter than surrounding tissue (I looked at it with him) - it was very subtle, but detectable and did turn out after VATS to be a met.

Take care,

Re: smallest tumors that turned up on your PET, PET/CT or PET/MRI ??

Posted: Mon Feb 11, 2019 5:33 pm
by Nordy1
Thank you all for the replies!

This gives me confidence to look at another facility if ours wont continue to test with other modes of scanning. CT tomorrow morning so I might possibly have an answer by Friday

thanks again,
Nordy1

Re: smallest tumors that turned up on your PET, PET/CT or PET/MRI ??

Posted: Mon Feb 11, 2019 5:42 pm
by LPL
Nordy1 wrote:Thank you all for the replies!

This gives me confidence to look at another facility if ours wont continue to test with other modes of scanning. CT tomorrow morning so I might possibly have an answer by Friday

thanks again,
Nordy1

Best of Luck tomorrow Nordy1 !!

Re: smallest tumors that turned up on your PET, PET/CT or PET/MRI ??

Posted: Sat Feb 23, 2019 10:23 am
by Nordy1
Hi All

Just thought I would update. The scans have shown no growth for the last 3 months so they called it stable. The kidney node is still indeterminate and the liver they think is NAFLD. I see the doctor in a couple weeks but I think they want to take a watch and see approach. Im not sure Im comfortable with this yet, they haven't done a PET or an MRI so i cant help but feel they should try something else first. I also wondered if a second radiologist opinion of the scans would help, not really sure if thats a thing though.

Im struggling....it feels like im giving up if I just agree to wait and see what happens. I know its a legitimate sometimes, but are 2 CT scan and an ultrasound reasonable diligence?


Nordy1