Clinical History
The patient is an 11 year-old male with Hodgkins disease being evaluated for progression of disease. He received an aggressive round of chemotherapy and 45 days later he had another PET scan prior to autologous bone marrow transplantation.
Technique
The patient received 6.6 mCi of F18 FDG and multiple whole body PET images were obtained. Comparison is made to his baseline PET scan from October 1999, February 2000 and January 2004. The patient's blood glucose was 91 mg/dl prior to the FDG injection.
Findings
1. On the January 2004 PET scan, there was increased metabolic activity which was present in the supraclavicular, mediastinal and AP window regions. The areas of supraclavicular region measured 0.53 sq.cm on slice 25. This area had a maximum SUV of 2.03. The area in the right paratracheal region with the highest uptake on slice 36 measured 1.06 sq.cm with a maximum SUV of 2.2. These areas currently do not have increased metabolic activity.
2. On the January 2004 PET scan there was also an interval development of increased metabolic activity in the paraaortic regions in the abdomen and pelvis, the highest area of SUV uptake measured 1.7 maximum SUV on slice 83 in the left periaortic region. These areas currently do not have increased metabolic activity.
3. There is normal physiologic activity within the brain, heart, and GU tracts.
Impressions
IMPROVED PET SCAN WITHOUT EVIDENCE OF ABNORMAL FDG UPTAKE TO SUGGEST A METABOLICALLY ACTIVE NEOPLASTIC PROCESS JUST PRIOR TO BONE MARROW TRANSPLANTATION.
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