Inflammatory lesions on PET

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plastikos
Posts: 343
Joined: Wed Jan 14, 2015 6:09 am

Inflammatory lesions on PET

Postby plastikos » Sun Sep 06, 2020 2:22 am

Hi everyone. Been a while since I logged on but like I always say “life gets in the way”. A good thing. But lately the pandemic gets in the way too. Not a good thing.

Update: I just had my first PET-CT in 6 months after stopping Pembro infusions early this year. Although the last year my onc just gave it every 3 months so technically I’ve been off protocol for more than a year. Findings are pretty much the same with no new findings suspicious for mets. But there was note of a tiny FDG avid lesion with low uptake (SUV 2.0) at my right scapula which was read as probably inflammatory. Onc thinks it’s a muscle strain or tear. To be honest, I played tennis the day before the PET thinking it wouldn’t be a problem. Has anyone had similar findings on their PET which eventually disappeared on the next one?
Last edited by plastikos on Sun Sep 06, 2020 10:52 am, edited 1 time in total.
St. IV Colon CA @ 37, male, Kras wild, MSI-high (2014)
11/2014 Right Hemicolectomy + Liver Resection
12/2014 - 6/2015 FOLFOX + Cetuximab
10/2015 - Recurrence liver
Liver resection 10/2015
FOLFIRI 11/2015 - 5/2016
Recurrence liver, nodes 11/2016
Pembrolizumab started 12/2016 -> pseudoprogression(?) -> biliary obstruction -> biliary stenting
Chemo 4x: most mets inactive and smaller on PET-CT
March 2017 - Back on Pembrolizumab again
Sept 2017 - SIRT - > NED
2019 NED

Rock_Robster
Posts: 517
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Inflammatory lesions on PET

Postby Rock_Robster » Sun Sep 06, 2020 6:15 am

I haven’t had this exact situation but I can understand your onc’s position. Uptake is borderline and it’s in an atypical location for a CRC met, and you did (what I’d consider) strenuous exercise the day prior heavily emphasising that side of your body (assuming you’re right-handed). So definitely worth being vigilant about but I’d say you’re a long way from freak-out territory right now. Still as they say, we miss more by not looking than not knowing.

Just for interest, the instructions my hospital gives for PETs is to do no exercise more strenuous than walking for 48 hours prior. Not a hard rule for me to comply with :)

Good luck,
Rob
38M Australia
10/2018 Dx RC, 12cm high
Mod diff, EMVI+ LVI+. 4 liver mets
pT3N1aM1a Stage IVa. MSS NRAS G13R
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0, Mar-20=2.2, May-20=1.9, Jun-20=2.1, Sep-20: 2.1
11/18 FOLFOX x6
3/19 Liver resect
5/19 25x pelvic radiation; complete met. response
07/19 ULAR w ileo, 1/27 LN+
08/19 Found liver spot
08/19 FOLFOX x1, FOLFOXIRI x1, FOLFIRI x5
12/19 Liver resect
02/20 Ileo reversed
03/20 NED (PET+MRI)
06/20 NED (CT+MRI)
07/20 Clear scope
09/20 NED (PET)

plastikos
Posts: 343
Joined: Wed Jan 14, 2015 6:09 am

Re: Inflammatory lesions on PET

Postby plastikos » Sun Sep 06, 2020 10:54 am

Rock_Robster wrote:I haven’t had this exact situation but I can understand your onc’s position. Uptake is borderline and it’s in an atypical location for a CRC met, and you did (what I’d consider) strenuous exercise the day prior heavily emphasising that side of your body (assuming you’re right-handed). So definitely worth being vigilant about but I’d say you’re a long way from freak-out territory right now. Still as they say, we miss more by not looking than not knowing.

Just for interest, the instructions my hospital gives for PETs is to do no exercise more strenuous than walking for 48 hours prior. Not a hard rule for me to comply with :)

Good luck,
Rob


Thanks Rob. This is reassuring. Good luck as well.
St. IV Colon CA @ 37, male, Kras wild, MSI-high (2014)
11/2014 Right Hemicolectomy + Liver Resection
12/2014 - 6/2015 FOLFOX + Cetuximab
10/2015 - Recurrence liver
Liver resection 10/2015
FOLFIRI 11/2015 - 5/2016
Recurrence liver, nodes 11/2016
Pembrolizumab started 12/2016 -> pseudoprogression(?) -> biliary obstruction -> biliary stenting
Chemo 4x: most mets inactive and smaller on PET-CT
March 2017 - Back on Pembrolizumab again
Sept 2017 - SIRT - > NED
2019 NED


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