Lung Mass
- Amanda Brautigan, CNMT, RT(N)
- Senior Student NMT, Medical College of Georgia
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- Rufus Poole, CNMT, Chief Technologist
- Emory Univeristy Hospital, Department of Nuclear Medicine
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- Mary Anne Owen, MHE, RT(N)
- Program Director, Nuclear Medicine Technology
- Medical College of Georgia
Patient History:
59 year old white female, smoker
for 30 years two packs a day…quit 6 years ago. She has been coughing up
blood with a persistent cough and difficulty breathing. A mass appeared in
her lung on CT, but she has had two negative bronchial washes.
Findings:
With no CT available from the hospital for comparison, the exact location of the increased areas of increased uptake are unknown at the time of dictation. What steps could be taken to prevent this shortfall in the future? There are several areas of intense focal F18 FDG uptake in the left superior mediastinum and left posterior hilum. Standard uptake values (SUV) were calculated and reported at 4 for some areas and others were as high as 10. These uptake values are most definitely associated with malignancy. What are the significant ranges or values for SUV?
Radiopharmacy:
10.6 mCi of F18 FDG were injected intravenously and the patient then rested quietly in a room alone for 45 minutes. Why Rest?
Procedure:
At 45 minutes the patient was asked to empty her bladder to minimize her dose and shine from the increased activity on her PET scan…and with hopes of getting a clear image of her pelvic area.
Positioning
The patient was laid down (supine?prone?) on the table and positioned with her arms above her head for a whole body scan.
How is the posiitoning different from SPECT imaging, if at all?
Instrumentation:
In the computer, whe was set up
for 4 beds meaning the scanner would move to 4 different positions to acquire
counts from her nose to below her pelvis. This is a length sufficient to
provide diagnostic information.
The acquisition was performed
with the septa out to increase the resolution and acquire as many true counts as
possible. There are upper and lower level discriminators (what
does this mean?) built into the software at 250 and 650 keV to account
for the 511 keV of the positron annihilation reaction and enough scatter to
provide a desirable target to background ratio.
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May 2002
Processing
How are these studies processed?