Treatment and Imaging Schedule for the ACRIN 6678 Clinical Trial
Patient Name:
Date of Birth:
IF ANY OF THE DATES LISTED BELOW CHANGE PLEASE CALL [ NAME(S)]
AND LET [ HER/HIM/THEM] KNOW SO YOUR PET SCANS CAN BE
RESCHEDULED TO MEET THE STUDY REQUIREMENTS
PHONE:
[Imaging and chemotherapy scheduling example.]
Type of Appointment
Date
Time / Instructions
GROUPS A, B, & C
1st PRETREAMENT FDG-PET/CT SCAN
GROUPS A AND C
2nd PRETREAMENT FDG-PET SCAN
CHEMOTHEARPY CYCLE 1
GROUPS A & B
POST 1ST CYCLE FDG-PET/CT SCAN
Confirm with [oncologist]
[time] nothing to eat & only
water to drink
CHEMOTHERAPY CYCLE 2
Confirm with [oncologist]
GROUP B (OPTIONAL)
FDG-PET/CT SCAN
[time] nothing to eat & only
water to drink
STANDARD OF CARE CT SCAN
[time] We can schedule your
CT scan to be done on the
same day as your PET scan so
the same I.V can be used for
both scans.