NAME: CHANDA BAI DOHARE AGE / SEX: 63 YRS / F

REF PHY: DR.SHYAM AGRAWAL MD DM PATIENT ID: NCH-2023-0213

TEST NAME: WHOLE BODY F 18 FDG PET-CT SCAN DATE: 29- APR- 2023

WHOLE BODY PET-CT SCAN

Clinical history: Patient is a follow up case of Ca stomach . Post-chemotherapy . Current PET-CT is being done
for further evaluation and disease status.

Procedure: Whole body FDG PET scan was acquired from vertex to mid thigh in a whole-body PET-CT scanner
(GE Discovery), one hour after intravenous injection of 370 MBq of 18F-FDG. High resolution, contrast CT scan
was also obtained of the same area. Oral contrast was administered for bowel opacification, over 90 min, before
the scan. Images were reconstructed using Q Clear algorithm and slices were reformatted into transaxial, coronal
and sagittal views. Semi-quantitative estimation of FDG uptake was performed by calculating SUV max value,
corrected for dose administered and lean body mass (g/ml).

Findings:
Physiological biodistribution :- noted in the parapharyngeal region, left ventricle, liver, spleen, kidneys and urinary
bladder

Brain:
Normal physiological tracer distribution noted in the brain parenchyma. No focal abnormal uptake noted in the
brain.

Note: All brain lesions may not be apparent on a PET/CT scan and a MRI can be performed where clinically indicated.

Head and neck:

Normal physiologic uptake noted in the nasopharynx, oropharynx, hypopharynx and larynx. Parotid and bilateral
submandibular glands demonstrate normal metabolic activity.

The thyroid gland shows homogenous pattern on CT. No abnormal FDG uptake is seen in the thyroid.

No significant cervical / supraclavicular lymphadenopathy noted.

Thorax:

Few subcentimetre sized non-FDG avid left supraclavicular lymph nodes are noted, largest one measuring about
0.5 cm in short axis diameter.

Few non-FDG avid pre paratracheal, AP window and subcarinal lymph nodes are noted, largest one in
pretracheal region measuring about 2.5 x 1.6 cm.

The heart and the mediastinal vascular structures are well opacified with I/V contrast. The trachea and main bronchi
appear normal.
No focal lesion or abnormal FDG uptake noted in the lung parenchyma.

Abdomen and pelvis:

Non-FDG avid wall thickening is noted involving fundus and body of stomach, maximum wall thickness
measuring about 0.9 cm.

Few non-FDG avid subcentimetre sized perigastric lymph nodes are noted, along the lesser curvature, largest
measuring about 0.5 cm in short axis diameter

The liver is normal in size and shape No focal intrahepatic lesion is noted. The intrahepatic biliary radicles are not
dilated. The portal vein is normal. No abnormal FDG uptake is noted in the liver parenchyma.

The gall bladder is well distended with no abnormal FDG uptake.

The pancreas and spleen appear normal on CT with no abnormal FDG uptake.

Bilateral adrenal glands appear normal in size with no abnormal FDG uptake. Both the kidneys appear normal in
size, shape and attenuation. No scan evidence of calculus or hydronephrosis is noted.

The opacified small bowel and rest large bowel loops appear normal in caliber and fold pattern.

No significant abdominal, retroperitoneal lymphadenopathy noted.

Urinary bladder is well distended with no abnormal FDG uptake.

Musculoskeletal system:

The visualized portion of the musculoskeletal system shows normal physiological tracer distribution.
IMPRESSION:
In a follow up case of Ca Stomach. Post chemotherapy. PET/CT scan shows:
 Non-FDG avid thickening of wall of stomach involving fundus and body of stomach - suggests
burnt out disease
 Non-FDG avid left supraclavicular, mediastinal, perigastric lymphadenopathy - suggests burnt
out disease
 No focal abnormal FDG avid lesion in rest of the body.

Dr ROMA Dr L P KASHYAP
MD Nuclear Medicine Senior Consultant
AIIMS, DELHI Nuclear medicine & PET-CT