CT results questionable after PET

Well, SUV of 2.5 is pretty low. They did the CT because it gives different info than the PET, and PET's are kind of notorius for lighting up a lot of things, scar tissue, infection, any inflammation at all can light up a PET.

So they might want to watch this for a couple of weeks and then repeat a CT, or even an ultrasound.

Is this something you can feel?

Well, SUV of 2.5 is pretty low. They did the CT because it gives different info than the PET, and PET's are kind of notorius for lighting up a lot of things, scar tissue, infection, any inflammation at all can light up a PET.

So they might want to watch this for a couple of weeks and then repeat a CT, or even an ultrasound.

Is this something you can feel?

Well, SUV of 2.5 is pretty low. They did the CT because it gives different info than the PET, and PET's are kind of notorius for lighting up a lot of things, scar tissue, infection, any inflammation at all can light up a PET.

So they might want to watch this for a couple of weeks and then repeat a CT, or even an ultrasound.

Is this something you can feel?

Low suv's on a PET such as your 2.5 are hardly conclusive.  A far more economical and revealing  followup would have been an ultrasound rather than a CT…..a lower option would have been a FNA……….Fine Needle Aspiration……………..a/k/a needle biopsy.

That you "know" a biopsy" is the best course given your results is really not  all that good of a decision.

Sure, follow your gut, but there is no reason to do invasive proceedures  based alone on a 2.5 suv uptake.  A aggravated mosquito bite can give a 2.5 on a PET.

I'm not diminishing your concerns, but would kindly suggest that you find a balance that is based upon science and not (no pun intended), knee jerk reactions.

Cheers,

Charlie S

Low suv's on a PET such as your 2.5 are hardly conclusive.  A far more economical and revealing  followup would have been an ultrasound rather than a CT…..a lower option would have been a FNA……….Fine Needle Aspiration……………..a/k/a needle biopsy.

That you "know" a biopsy" is the best course given your results is really not  all that good of a decision.

Sure, follow your gut, but there is no reason to do invasive proceedures  based alone on a 2.5 suv uptake.  A aggravated mosquito bite can give a 2.5 on a PET.

I'm not diminishing your concerns, but would kindly suggest that you find a balance that is based upon science and not (no pun intended), knee jerk reactions.

Cheers,

Charlie S

Low suv's on a PET such as your 2.5 are hardly conclusive.  A far more economical and revealing  followup would have been an ultrasound rather than a CT…..a lower option would have been a FNA……….Fine Needle Aspiration……………..a/k/a needle biopsy.

That you "know" a biopsy" is the best course given your results is really not  all that good of a decision.

Sure, follow your gut, but there is no reason to do invasive proceedures  based alone on a 2.5 suv uptake.  A aggravated mosquito bite can give a 2.5 on a PET.

I'm not diminishing your concerns, but would kindly suggest that you find a balance that is based upon science and not (no pun intended), knee jerk reactions.

Cheers,

Charlie S

Laurie, I will repeat something i have often said, PET scans do not automatically pick out tumors.  As Linda pointed out they show many spots, the problem is "What do the spots mean?"   all a PET scan shows is locations were glucose has gathered.  This is the reason that PET scans are famous for both false positives and false negatives.  Since Tumors tend to absorb glucose, the lighted spots are something to check out as a posible trouble location. One way they are checked out is by CT's which give a much more accurate indication of size and therefore by repeated CT's a more definite indication of growth or laack thereof.  I have had many more false positives on PETs than I have had tumors.  I have also had several tumors that I found and could tell that they were changing size (growing) that the PET scan did not identify.  When I discussed them with my surgical specialist oncologist, he cut out the ones I wanted him to.and left the ones where I knew I had previous injuries.  None of the previous injury spots has ever changed on the CT scans.  Of the spots I said were changing, the ones I suspected of being melanoma were.  The one location that I did not think was melanoma, but was growing fast was removed for me and was a fatty growth, not a melanoma.

  Is the back of your knee sore or does it have a changing lump in it?  Have you ever hurt that knee? They may want to do a Fine Needle Aspiration (FNA biopsy) of the node to see what they can find, especially if it is changing.  Since you have aalready had the melanoma show up much higher it would be less likely for the popliteal nodes to now be receiving the melanoma cells.  Not impossible , but in most caes the disease goes to the groin nodes, not the knee nodes.  Operations in this area area quite delicate and need a specialist familiar with operating in this area.

Here are a couple of URLs to check out.

http://en.wikipedia.org/wiki/Popliteal_lymph_nodes

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1784092/

   You will note in this article that it is recommended that someone that is very familiar with the knowledge of anatomy and surgical technique about popliteal lymphadenectomy are required to make preservation of structures that if injured, can produce a permanent, considerable disability.

Laurie, I will repeat something i have often said, PET scans do not automatically pick out tumors.  As Linda pointed out they show many spots, the problem is "What do the spots mean?"   all a PET scan shows is locations were glucose has gathered.  This is the reason that PET scans are famous for both false positives and false negatives.  Since Tumors tend to absorb glucose, the lighted spots are something to check out as a posible trouble location. One way they are checked out is by CT's which give a much more accurate indication of size and therefore by repeated CT's a more definite indication of growth or laack thereof.  I have had many more false positives on PETs than I have had tumors.  I have also had several tumors that I found and could tell that they were changing size (growing) that the PET scan did not identify.  When I discussed them with my surgical specialist oncologist, he cut out the ones I wanted him to.and left the ones where I knew I had previous injuries.  None of the previous injury spots has ever changed on the CT scans.  Of the spots I said were changing, the ones I suspected of being melanoma were.  The one location that I did not think was melanoma, but was growing fast was removed for me and was a fatty growth, not a melanoma.

  Is the back of your knee sore or does it have a changing lump in it?  Have you ever hurt that knee? They may want to do a Fine Needle Aspiration (FNA biopsy) of the node to see what they can find, especially if it is changing.  Since you have aalready had the melanoma show up much higher it would be less likely for the popliteal nodes to now be receiving the melanoma cells.  Not impossible , but in most caes the disease goes to the groin nodes, not the knee nodes.  Operations in this area area quite delicate and need a specialist familiar with operating in this area.

Here are a couple of URLs to check out.

http://en.wikipedia.org/wiki/Popliteal_lymph_nodes

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1784092/

   You will note in this article that it is recommended that someone that is very familiar with the knowledge of anatomy and surgical technique about popliteal lymphadenectomy are required to make preservation of structures that if injured, can produce a permanent, considerable disability.

Laurie, I will repeat something i have often said, PET scans do not automatically pick out tumors.  As Linda pointed out they show many spots, the problem is "What do the spots mean?"   all a PET scan shows is locations were glucose has gathered.  This is the reason that PET scans are famous for both false positives and false negatives.  Since Tumors tend to absorb glucose, the lighted spots are something to check out as a posible trouble location. One way they are checked out is by CT's which give a much more accurate indication of size and therefore by repeated CT's a more definite indication of growth or laack thereof.  I have had many more false positives on PETs than I have had tumors.  I have also had several tumors that I found and could tell that they were changing size (growing) that the PET scan did not identify.  When I discussed them with my surgical specialist oncologist, he cut out the ones I wanted him to.and left the ones where I knew I had previous injuries.  None of the previous injury spots has ever changed on the CT scans.  Of the spots I said were changing, the ones I suspected of being melanoma were.  The one location that I did not think was melanoma, but was growing fast was removed for me and was a fatty growth, not a melanoma.

  Is the back of your knee sore or does it have a changing lump in it?  Have you ever hurt that knee? They may want to do a Fine Needle Aspiration (FNA biopsy) of the node to see what they can find, especially if it is changing.  Since you have aalready had the melanoma show up much higher it would be less likely for the popliteal nodes to now be receiving the melanoma cells.  Not impossible , but in most caes the disease goes to the groin nodes, not the knee nodes.  Operations in this area area quite delicate and need a specialist familiar with operating in this area.

Here are a couple of URLs to check out.

http://en.wikipedia.org/wiki/Popliteal_lymph_nodes

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1784092/

   You will note in this article that it is recommended that someone that is very familiar with the knowledge of anatomy and surgical technique about popliteal lymphadenectomy are required to make preservation of structures that if injured, can produce a permanent, considerable disability.

hi laurie. 

when i was dignosed in 2008 – my mel was on my right ankle. we did the WLE and SNB and when the groin nodes tested positive, we scheduled the LND. my LND was scheduled for a monday, we did a PET on the friday before, just so they could get a solid view of the nodes that were lighting up.

Sunday afternoon my surgeon called me and told me that he was reviewing the results of my PET and told me that the popliteal fossa nodes were lit up as well and would i give him permission to remove them the following day. i did.

I was told that it is rare that mel travels to these nodes but that its not unheard of. further testing proved that the nodes were extracapsulated (exploding) with mel – so removing them was the best thing that could have been done.

if i was you and the option is there to remove them popliteal nodes, i say remove them…. but this also increases your chance of lymphadema – but i would rather have LE than mel in me!!

Please let me know if you have any questions… i would be happy to answer them.

djpayn (dawna)

hi laurie. 

when i was dignosed in 2008 – my mel was on my right ankle. we did the WLE and SNB and when the groin nodes tested positive, we scheduled the LND. my LND was scheduled for a monday, we did a PET on the friday before, just so they could get a solid view of the nodes that were lighting up.

Sunday afternoon my surgeon called me and told me that he was reviewing the results of my PET and told me that the popliteal fossa nodes were lit up as well and would i give him permission to remove them the following day. i did.

I was told that it is rare that mel travels to these nodes but that its not unheard of. further testing proved that the nodes were extracapsulated (exploding) with mel – so removing them was the best thing that could have been done.

if i was you and the option is there to remove them popliteal nodes, i say remove them…. but this also increases your chance of lymphadema – but i would rather have LE than mel in me!!

Please let me know if you have any questions… i would be happy to answer them.

djpayn (dawna)

hi laurie. 

when i was dignosed in 2008 – my mel was on my right ankle. we did the WLE and SNB and when the groin nodes tested positive, we scheduled the LND. my LND was scheduled for a monday, we did a PET on the friday before, just so they could get a solid view of the nodes that were lighting up.

Sunday afternoon my surgeon called me and told me that he was reviewing the results of my PET and told me that the popliteal fossa nodes were lit up as well and would i give him permission to remove them the following day. i did.

I was told that it is rare that mel travels to these nodes but that its not unheard of. further testing proved that the nodes were extracapsulated (exploding) with mel – so removing them was the best thing that could have been done.

if i was you and the option is there to remove them popliteal nodes, i say remove them…. but this also increases your chance of lymphadema – but i would rather have LE than mel in me!!

Please let me know if you have any questions… i would be happy to answer them.

djpayn (dawna)