XXX Nuclear Facility 6021 University Blvd., Suite 500 Ellicott City, MD 21043 Phone (123)123-1234 Fax (123)123-1234 Patient Name: Doe, John ID Number: 123456 Date of Birth: 4-2-63 Sex: Male Referring Physician: Dr. Jones Date of the Exam: 4-1-12 Clinical Indications: Restaging Colorectal Carcinoma Radiopharmaceutical: 11.3 mCi FDG IV Whole Body PET/CT Study PROCEDURE: Following the intravenous administration of 11.3 mCi of FDG, image acquisition on a dedicated PET/CT unit was performed at one hour post injection. A preliminary CT study encompassing the skull base, neck, chest, abdomen and pelvis was performed for purposes of attenuation correction and anatomic localization. The proximal thighs were also included. A recent CT study from 1/18/12 is available for comparison. FINDINGS: There is symmetric increased uptake within longus coli muscles in the nasopharynx and this is probably a variation of normal. Increased uptake within the tongue and floor and mouth is probably also physiologic in nature. There is minimal asymmetric uptake within the scalene muscles. This is probably physiologic in nature. The same is true of activity within the vocal cord distribution. Chest: The patient has clearly had a prior sternotomy. There are no significant chest wall or axillary abnormalities. A tiny spiculated density in the left apex is probably small pleural or parenchymal scar and this is not FDG avid. Within the posterior segment of the right upper lobe, there is a juxtapleural spiculated mass which is 2.2 X 2.3 cm. in diameter. This shows a maximum SUV of 13.59. Within the mediastinum, there appears to be an enlarged pre-tracheal lymph node, which is 2.7 X 2.2 cm. This shows a maximum SUV of 3.1and this should be regarded as being suspicious for nodal metastases. Mediastinal clips are identified. There appears to be a lower paravertebral loculated right pleural effusion. The volume of fluid is less than seen on the prior CT study. This collection does not appear to be FDG avid. There may be some minimal pleural thickening in the left base, with some minimal left basilar ateslectasis. Abdomen: The patient has a non-FDG avid 2.2 cm. lesion within the superior right lobe of the liver. This is consistent with a cyst. This did not enhance at the time of the prior CT study. There are no splenic abnormalities. Lumbar spondylosis and scoliosis are present. Facet arthropathy is present as well. Normal bowel activity is seen. Pelvis: Normal physiologic bowel activity is identified. There are no pelvic masses. With the use of bone window settings, there are no osteolytic or osteoblastic lesions. There are no FDG avid lesions within the visualized portion of the axial skeleton. IMPRESSION: 1. 2. 3. 4. There is a moderately FDG avid 2.3 cm. spiculated mass in the posterior segment of the right upper lobe. This should be regarded as a pulmonary neoplasm until proven otherwise. There is an enlarged pretracheal lymph node at the level of the carina. This shows mild FDG avidity. This should be regarded as being suspicious for lymph node metastases. Non-FDG avid hepatic cysts. There are no signs of extrathoracic metastatic disease. Small loculated right pleural effusion. This is non-FDG avid. Mary Beth Farrell, MD (electronically signed) Date of interpretation: 4-2-12 Date of final report: 4-3-12 PET-CT Whole Body Colorectal Restaging Report (SAMPLE) 1 NOTE: This is a SAMPLE only. Protocols submitted with the application MUST be customized to reflect current practices of the facility.