case studies PET / CT

Two very different cases really served to underline how helpful PET / CT can be. Both patients had a SPN (solitary pulmonary nodule) identified on a chest X ray. Both went for CT and the SPN was confirmed. Needle biopsy was inconclusive so both patients were referred for PET. One patient had no areas of increased FDG uptake, indicating a benign nodule. The other patient had significant uptake around the perimeter of the SPN. A repeat biopsy will be performed but this time guided by the PET findings the perimeter of the nodule will be sampled. As the TNM classification was T2N0M0 the nodule should be suitable for resection (depending on the histology). These patients were unusual in that before the PET scan there was only a possibility of cancer. Many of the patients already know (from prior histology) and some have only just received the news. The staging of the cancer that PET makes possible will often determine if curative treatment is possible and the patients are often fully aware of this.