July 2005 Case Study

July 2005

A patient with a history of breast cancer is referred to nuclear medicine for a bone scan and PET scan to evaluate possible metastatic spread of the disease.

Patient Medical History
-Breast Cancer
-Right mastectomy 1996
-Chemotherapy
-Occasional hip pain
-No fractures, trauma, or falls

Study was not satisfactory due to excess background from a PET scan that was performed earlier in the day. The 511 keV of F-18 is much too high for the gamma camera resulting in scatter.

This study is interesting because it demonstrates what can happen if procedures are not scheduled correctly. It is important that other exams that the patient may need will not be scheduled at a time that will interfere with nuclear medicine exams. This mistake greatly deteriorated the quality of the scan. The patient had to be rescheduled for another bone scan three days later. The second bone scan resulted in a high quality image.

HDP + FDG

Repeat Bone Scan Three Days Later

Radiology Report
-Interpretation: Increased activity in the feet and in the left wrist consistent with degenerative/arthritic process. No focal areas of abnormal activity to suggest metatstatic disease in the included portions of the axial and appendicular skeleton.

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Case study submitted by Krystin Echevarria