Prostate Cancer - 76-year-old male for restaging of prostate cancer

History
This is a 76 year old male with prostate cancer diagnosed February 2002, status post radiation therapy most recently in April 2003. PET/CT scan in November 2004.

Dosage
11.4mCi F-18 FDG was administered IV per protocol to the right arm.

Procedure
The patient was scanned with the arms up from the level of the eyes down to the proximal femurs approximately 90 minutes post injection per protocol.

PET/CT Findings
NECK: There is no definite focal increased activity or asymmetry in the cervical nodal regions or in the visualized portion of the brain. Asymmetric laryngeal uptake is likely physiologic.

CHEST: Mild activity within the bilateral apical scarring can be inflammatory. Diffuse increased FDG uptake in the posterior right lung (maximum SUV 4.8) corresponds with the irregular air space abnormality on CT scan. No other definite focal increased activity is identified in the remaining lung parenchyma, specifically to correspond with the remaining non calcified nodules on CT scan. There is multifocal bilateral hilar, subcarinal, and paraesophageal mild to moderate uptake, with the most intense right hilar activity with an SUV of 6.6. Distal esophageal mild activity is non specific and can be inflammatory. There is no definite focal increased activity in the bilateral axillary regions.

ABDOMEN: No focal increased activity is identified in the liver, spleen, adrenal glands, or nodal regions of the abdomen. Diffusely increased right colon activity is non specific, likely related to contrast filled bowel.

PELVIS: Small focal increased right inguinal activity is mild (maximum SUV 2.3) corresponding with a small node on CT scan anterolateral to the symphysis pubis. No other focal increased activity is identified in the remaining nodal regions of the pelvis. Activity in the region of the prostate bed is mild and diffuse, which is non specific and can be physiologic.

Impression
1. Mild diffuse posterior right lung activity and more prominent bilateral hilar and
    mediastinal focal uptake can be inflammatory, although a neoplastic process cannot
    be completely excluded.

2. Small mild right inguinal focal uptake is non specific. Follow up is recommended.

Courtesy of
University of Tennessee Medical Center
David Townsend

NOTE: This PET/CT scan was done as part of a research study, and is not intended for clinical use.