Case studies
Case study: lung cancer
Clinical history: This patient was referred for assessment of a mass in the left lung.
Findings: There was high uptake of FDG consistent with lung cancer but no evidence
of spread elsewhere. The mass was biopsied and shown to contain non-small cell lung
cancer. The patient was treated with surgery.
Teaching points: PET/CT is used to determine the ‘stage’ of lung cancer (whether it
has spread from the lung cancer elsewhere in the body). This helps to decide on the
best treatment.
-1-
Case study: brain tumour
Clinical history: This patient was treated with surgery and radiotherapy for a brain
tumour in the past. He developed new symptoms suggestive of recurrent cancer. MRI
scan showed changes which could have been due either to recurrent cancer or to
radiotherapy treatment.
Findings: PET showed increased uptake of FDG at two places in the left temporal
lobe consistent with recurrent cancer.
Teaching points: PET can be used to differentiate changes due to recurrent cancer
from changes associated with treatment which can be difficult using ‘anatomical’
imaging like MRI and CT.
-2-
Case study: myocardial viability
Clinical history: This patient with coronary heart disease and heart failure was
referred for PET scanning to determine if there was irretrievable damage to the heart
muscle or if the heart muscle was ‘hibernating’.
Findings: There was good uptake of FDG in the areas of damaged heart muscle
consistent with ‘hibernating’ heart.
Teaching points: PET can differentiate between heart muscle, which is ‘dead’ and
heart muscle which is ‘alive’ or ‘hibernating’. Muscle which is ‘hibernating’ can
sometimes be improved with coronary artery bypass surgery or by opening up a
narrowed coronary artery with a balloon inserted into the artery (angioplasty).
-3-