Clinical case - PET sensitivity reveals a 3mm metastasis

3mm metastasis

Who we are

 

Diana Salvo, MD
Clinical Director and Head of Institute of Nuclear Medicine

Annibale Versari, MDM
Senior Clinical lecturer in Multimodality Imaging

 

 

Federica Fioroni, MS
Medical Physicist

Archipedale Santa Maria Nuova
Reggio Emilia, Italy

The Reggio Emilia ASMN PET Center was created in 2000. In 2002, a 10 MeV Cyclotron (Minitrace GE) was installed in order to produce clinical 18F-FDG and 18F-Choline. A protocol to produce 18FLT and 18F-MISO will also be available soon for research purpose.

 

Patient History

Female - 57 years old - 167cm - 65kg

This patient is undergoing PET staging before surgery.

29th August 2007: Whole-body PET/CT positive

1st September: Whole-body bone scintigraphy negative

3rd September: Sentinel lymph node positive

Acquisition

Scanner: GE Discovery STE

PET acquisition: Whole-body acquisition

  • 3D acquisition
  • Acquisition time: 2 min 30 per bed position
  • Dose: 240 MBq of 18F-FDG

CT acquisition: Whole-body acquisition

  • kVp: 120 - mA: 80

Findings

                                    

Fused coronal view shows focal                Pre-surgery VR showing axillary node 3D
uptake in right axillary node                      position and primary lesion

                                    

Axial fused view of the primary lesion           

                                    

Fused Axial view of right axillary node       Fused Coronal view of right axillary node

Conclusion

The lesion showed by the “other modality” was confirmed in the right breast.

PET pointed out the presence of a 3mm micrometastasis in the right axillary, and changed the final staging and hence the therapy choice.