I was wondering about others' expectations regarding a radiologist's PET scan report. Until the last one in December, mine have been quite thorough. The previous radiologist listed a sample of ten bone mets, compared the SUV number to the previous report and indicated the PET image where the met can be seen. But the latest report, done by a different radiologist was a lot less detailed. For the skeletal section he said, "essentially no change" and listed 4 mets with the SUV but no comparison. I'm not unhappy with the result but I still think he should have listed more than 4 mets and done a comparison, especially for future reference. What are your thoughts? Am I expecting more than is necessary?
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HelenWi
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Hi HelenWi. First of all congratulation on your stable scan results. 👏 As to your question around the reading and reporting of scan reports there is a general consensus from radiologists I have talked to that surveillance scans done regularly for patients with known metastatic disease are viewed at using a slightly different lens as opposed to those that are truly diagnostic with intent of cure. In general they are comparing it to the previous one on file and just looking for any changes that would indicate suspicion or progression. With bone mets there is no real advantage in reporting sizes or SUV uptake of each met. Bone mets show differently whether they are lytic or sclerotic at the time of the scan and vary with each scan. They are always present. As for comparison from scan to scan the radiologist always has the access to any scan to go back to if there was a question. Take care.
Hi. I had my first cat scan ever in Nov. of 2022, right after I had passed a kidney stone ... at least that's what I'm thinking it was because of the horrible pain and then a bit of blood in my urine the next morning but all the other pain and suffering was gone. It was SOMETHING I passed anyway, sorry I don't know, but I had spent the entire night in the ER and they did nothing for me so when I started feeling better the next morning I checked myself out (more to it but I won't go into it all right now); anyway, a day or so later I had the petscan and evidently it looked so horrible that since then, over a year ago, the cancer center I go to hasn't even recommended one bone scan or CT and he had told me over a year ago I had six months. My hypothesis, and it is strictly mine, from all I've read is that great inflammation will show up like cancer on a CAT ... anyone else heard of this? Sorry to throw all this out there, I'm such a mess, but I do feel good most of the time and only hurt a bit when the barometric pressure drops. Sometimes I think it's all done with lights and mirrors. I take Letrozole and that's it for now, I stopped Ibrance on my own because of reading the trial results but I may take it again if necessary. When I stopped it, and only taking the letrozole the last few months, my CA 27-29 and CA 3-15 both dropped over 75 points each, the best they've been in years, next round I'm expecting they will approach normal and I'm praying I'm right. I hope I don't hurt anyone with my experiment of one but one thing I know is we're all different and what's good for one may make another really sick, I myself have a very delicate system, so I already knew coming into this I would not be able to handle chemo. I ask the Holy Spirit to lead and guide me in my choices and He does a really great job because He alone knows the ending from the beginning. Jesus loves you and He is quite real. HE alone holds my tomorrows. God bless you and heal us all in Jesus name, amen! <3
Don't you want to get a new CAT? Obviously, that one was messed up by what was probably a kidney stone raking its way out.
Inflammation is inflammation. I had an auto-immune disease that was tracked only with inflammation numbers on a blood test. I got a couple of kidney stones and the inflammation numbers shot up, and they doubled the dose of prednisone I was on. I was in the hospital for a few days. A friend brought my laptop and I was the one who figured out it was the stones, not the auto-immune disease that caused the increase in inflammation (and I read that I would not pass them on my own because of the inflammation, so the urologist yanked them out). I read recently (as I always suspected) that being on a high dose of immune suppressants can allow mbc to bloom, as mine did, from 0 to 50 in few months.
Have they? I have to wonder ... the worst that has happened to me is when I got the shingles summer of last year due to my low immune system from the ibrance. I wonder how many have been made WORSE by some of these drugs, I am becoming very skeptical of all of it; forgive me, I am just being honest about my feelings. <3 xo
Glad to hear your good results. My scans vary depending on the radiologist. I always ask the doctor’s opinion to see if there are any major discrepancies. Some radiologists are more chatty than others for sure.
Thanks, Nocillo. Interesting to hear that your reports also vary by radiologist. To me it seemed that more detail means they did a more thorough inspection. But I guess that the key thing is to catch progression.
Not a PET but I had a CT Bone Scan that scared me half to death this past spring, once I spoke to my oncology team I had a better understanding. The person reviewing the scan went all the way back to the beginning and compared years of scanning there were pages of notes.
Turns out it was someone young and eager; there were pages of notes but as for recent developments I was pretty stable!
That being said I have since developed some spinal issues that are now getting MRI’s and being watched by a surgeon.
Tammy:Pardon me for chuckling, but I am picturing you getting that HUGE deck of results and wondering....WHAT is going on? Especially with the writing of all the numbers for prior years. I would be thumbing through them frantically.
I generally have CT scans. They usually make comparisons to the last one and any general trend. The oncologist talks them through and raises any concerns. That's enough for me as I don't want to get bogged down in detail. At first I wanted all details but now nearly four years in I'm glad to be well and able to enjoy my life. So I put the detail to one side and focus on living. Good luck. X
Glad to hear you had good results from your scan. So my last PET scan report was very detailed, more detailed than usual. I told my doctor I was very happy with having so much information. She said from a doctor's perspective, more detail is not necessarily better. They are just looking for information on the final results, whether there is progression or the patient is stable. She also said each radiologist differs in how they read the scans and do the reports. Best wishes to you.
I had a similar scare when the reader of my first PET following treatment for a bone met indicated that there was progression in the area where we thought the treatment was working well. My orthopedic oncologist explained to met that the scan was NOT in fact showing progression of the lesion but ACTIVE bone repair going on. According to him they look EXACTLY the same on a PETscan. It can take several weeks or even months for the scan to catch up to reality. In my case he said that the dramatic clinical improvement was much more important as a gauge if the new drug working. He was correct, as two scans later it was read as "stable". But until I talked with him I was a mental basket case bc the report made no sense with how great I was feeling and I did not know what to think other than terror!! My regular oncologist did not even know this about PET scans so we both learned something! Now I depend ONLY on the interpretation of my ORTHOPEDIC oncologist in regards to bone mets.
Sadly a few weeks later that drug did in fact stop working so I was switched to an oral chemo (capcitabine/Xeloda) which has been marvelous. Cancer markers dropped 6 points after the first cycle and back to close to normal after the 3rd cycle. Due for my first PET after these great blood tests in 2 weeks and expect to see good results. I always schedule an appointment with the orthopedic oncologist right after these scans so I get the correct interprtation from him regardless of what the PET report says. My only mets have been to the bone so he has been a sanity saver for me more than once!
If anyone on this forum is in the LA area he is at UCLA Health and I would be happy to refer you to him. I got his name from my bf's daughter who is an orthopedic resident and worked under him for a while. He is the BEST of the BEST!!
Happy New Year and the best of health to everyone in this new year =)
I hadn't either until my PT mentioned that I should check into it when I found out my pain was not caused by a sports injury but rather by the cancer in my scapula spreading. He gave me some referrals but I went with my bf's daughter's recommendation and I'm so glad I did bc he's fantastic! If you are in southern California he's Dr.Bernthal at UCLA Health. She also did med school in Toledo, Ohio, residency in North Carolina, and is now in Corvallis, Oregon so she probably has referrals in those places as well.
My oncologist tells me not to pay too much attention to the radiologist's report. She said they err on the side of caution. She calls the radiologist (they vary a lot in detail; one talked about my teeth when I was getting ONJ; another mentioned arthritis in my broken knee; others stick to cancer) and gets more info, and then she tells me what it really means.
Final note: So my oncologist passed my request for more detail to the radiologist who had done the previous, more detailed reports who also happens to be the head of the radiologists. He called me and said that he would create a new report more in line with the previous ones.
That happened to me too at the end of November. My PET scan read as if things were stable and they weren't. I asked my oncologist and she didn't know why, but I'm going to pursue it too. I just found out yesterday, and am starting Xeloda Tuesday
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but I still think he should have listed more than 4 mets and done a comparison, especially for future reference. What are your thoughts? Am I expecting more than is necessary?
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