PET Interesting Case...........

A 67 year old woman with a history of breast carcinoma in May of 1999 was originally treated with lumpectomy, followed by three months of chemotherapy and subsequently a six week course of radiotherapy.

She was referred for 99mTcHDP bone scintigraphy because of unexplained, persistent right hip pain. This examination was unremarkable except for a focus of minimally altered osteogenesis in the lower thoracic spine that was interpreted as probably degenerative change.

Because of clinical suspicion for occult metastatic disease, the patient was referred for a PET scan. This examination revealed numerous unsuspected and otherwise undetected foci of metastatic disease in the skeletal system that explained the patient's symptoms. In addition, multiple foci of tumor were identified in the soft tissues elsewhere. This example highlights the difference and advantages of patient treatment and management with PET scanning. Bone scintigraphy revealed no substantive bone reaction to the tumor, while the hypermetabolism of the tumor in the bone marrow was exquisitely demonstrated by the PET scan.

FOCAL POINT
PET scanning reveals foci of hypermetabolism associated with metastatic and primary malignant disease with more sensitivity and specificity than anatomically based imaging procedures such as CT, US and MRI. Further, this demonstrates that a sensitive modality for detecting altered osteogenesis, bone scintigraphy, is of lesser utility in patient care and tumor staging than metabolic imaging that reflects the hypermetabolic state of most malignancies. PET scanning should be the first imaging procedure for staging in a majority of cases wherein the diagnosis of malignancy is known or suspected.

PET Patient Comments........

"For two years, I thought I felt a lump in my breast, but conventional testing told me I was fine. Those tests were wrong."
PET confirmed the patient's suspicion.

"The doctors said I had high blood pressure, so I volunteered for a research study on my heart. I still can not believe what they found."
PET saved the patient's life.

"I hadn't had a physical in years, and my goodness was I surprised when something showed up on my chest x-ray. I felt fine! Imagine my shock when my doctor wanted to schedule major surgery."
PET determined an alternative course of treatment.