Pet Ct Update
Transcript of Pet Ct Update
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PET CT CASE STUDY
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CLINICAL HISTORY
A 60 years old male patient presented with
swelling in left side of neck since 2 months.
Biopsy done from the left cervical lymphnode :
Metastatic Squamous cell carcinoma
CT scan of neck showed enlarged cervical
lymphnodes along the great vessels of neck at
level II & III on left side. No primary malignantmass lesion was found.
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Image # 1 : It shows a well-definedheterogeneously enhancing FDG avid soft-tissuedensity lesion involving right tonsilar fossa (max.SUV: 5.0) with a well-defined FDG avidheterogeneously enhancing nodal mass lesionalong the great vessels of neck on left side atlevel II and III (avg. SUV: 11.9).
Images # 2 : A small well-defined FDG avidhypodense lesion is seen involving segment VIIof right lobe of liver (avg. SUV: 4.4)
Findings
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Image # 3 is coronal image of whole body
PET CT which shows a well-defined
heterogeneously enhancing FDG avidsoft-tissue density lesion involving right
tonsilar fossa with a well-defined FDG avid
heterogeneously enhancing nodal mass
lesion along the great vessels of neck onleft side at level II and III.
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DIAGNOSIS
Metabolically active malignant mass
lesion involving right tonsilar fossa
region with left cervical and hepatic
metastasis.
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BIOPSY:
From right tonsilar fossa : Squamous cell
carcinoma.
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DISCUSSION
PET CT is the modality of choice for
evaluation of metastatic disease with
unknown primary disease. PET CT
identifies primary malignant site (T-
staging), lymphnodal spread (N-staging)
and distal metastasis (M-staging). In a
single examination complete oncologicalwork up of the disease is possible.
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CASE STUDY :
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CLINICAL HISTORY
A male aged 54 years presented with dysphagiafor solids since 1 month.
Upper GI scopy was done & showed malignantlesion involving mid oesophagus, biopsy wastaken.
Biopsy :
Base line CT scan of thorax was done & showedmalignant mass lesion involving mid
oesophagus with mediastinal lymphadenopathy. A solitary left cervical lymphnode was found atlevel IV.
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FINDINGS
Image # 1 shows irregular circumferential wallthickening involving proximal lower thoracicoesophagus with luminal narrowing (max. SUV:
24.7).No evidence of loss of perioesophageal fatplanes.
Image # 2 shows an enlarged leftsupraclavicular nodes (level 1) (max. SUV:5.31).
Image # 3 shows an enlarged left gastric node(level 17) (max. SUV: 6.43).
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Image # 4 is coronal image of whole body
PET CT shows FDG avid oesophageal
malignant wall thickening with mediastinal,
left cervical and left gastric lymphnodes.
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DIAGNOSIS
Metabolically active malignant wall
thickening involving proximal lower
thoracic oesophagus with mediastinal,
left gastric and left supraclavicular
metastatic lymphadenopathy.
According to TNM classification: -
T2N1M1b ± Stage IV B.