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Old 08-21-2007, 10:21 PM   #1
DonnaNY
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Pet/CT scan questions

Hi all , My mom has to go have a Pet/CT scan on September 4th. Its the kind where you drink the contrast, and get injected with something as well. She had a question or two that she thought maybe someone here might be able to answer. They told her she had to drink a quart of water before this test, did anyone here have to drink that much water before this test? Also they said her last meal should be high in protein, she does not eat breakfast so this meal would be eaten late the night before. What kinds of food did you eat before this test? Thanks for any info. God Bless!



With love, Donna
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Old 08-22-2007, 02:08 AM   #2
tousled1
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My PET/CTs were always scheduled in the morning. The night before I just ate my regular meal and when I woke in the morning I had nothing to eat or drink. When I arrived at the imaging center they injected me (via IV) then gave me a bottle of that wonderful stuff to drink (really not too bad since they are flavored) then they would take me to a room where I would just relax for about half an hour. After that it was into the scan. If your mother gets claustrophobic she may want to ask for doctor for Ativan to take before the procedure.
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Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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Old 08-22-2007, 10:30 AM   #3
Stephanie
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I had a PET/CT yesterday, and my mom has had numerous PET/CTs, and I don't think she's ever had to drink that much water before hand. I didn't yesterday, but neither of us have had it with contrast, just the radioactive isotope or whatever it is they inject. Maybe the water is for flushing out the contrast after the scan? We haven't had the high-protein meal instructions--just ate whatever the night before.

Something important that they sometimes forget to mention is no exercise the day of the scan or the day before the scan. This restriction includes gardening and house cleaning. If you use your muscles too much the day before, the muscles will take up the glucose instead of the tissue that is being scanned, and it can affect the PET results.
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Old 08-22-2007, 02:40 PM   #4
Lolly
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I've always been told the last meal should be low carbohydrate and fat.
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Sept.'99 - Dx.Stage IIIB, IDC ER/PR-, HER2+++ by IHC, confirmed '04 by FISH. Left MRM, AC x's 4, Taxol x's 4, 33 Rads, finishing Tx May 2000. Jan.'01 - local/regional recurrence, Stage IV. Herceptin/Navelbine weekly till NED August 2001, then maintenance Herceptin. Right Mast. April 2002. Local/Regional recurrence April '04, Herceptin plus/minus chemo until May '07. Gemzar added from Feb.'07-April '07; Tykerb/Abraxane until August '07, back on Herceptin plus Taxotere and Xeloda Sept. '07. Stopped T/X Nov. '07, stopped Herceptin Dec. '07, started Avastin/Taxol/Carboplatin Dec. '07. Progression in chest skin, stopped TAC March '03, started radiation.

Herceptin has served as the "Backbone" of my treatment strategy for over 6 years, giving me great quality of life. In 2005, I was privileged to participate in the University of Washington/Seattle HER2 Vaccine Trial.
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Old 08-22-2007, 04:12 PM   #5
Brenda_D
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When I had my Pet/Ct, they said nothing containing sugar the day before, and nothing after midnight. I just got the injection. I didn't have to drink anything.
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Old 08-22-2007, 04:45 PM   #6
chrisy
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For the PET/CT, they do want you to have as little "extra" glucose in your system as possible, so that the only glucose is the radioactive one they inject. That would jive with the "last meal should be protein" recommendation.

I've also been instructed to drink water but I don't remember why. Maybe to help flush the contrast out. They inject the glucose then you have to wait 45 minutes - so they give me a bunch of water to drink while I'm waiting, then have me empty my bladder so I can handle laying in the scanner for the next half hour! Sorry if TMI Afterward, they also have EVERYONE IN THE BUILDING tell me to drink lots of water and sometimes they give me a water bottle on the way out the door.

For PET/CT I've not had to drink the contrast - although I did for CT only. Not too disappointed on that, since they give "berry smoothie" a bad name.

Also, Stephanie's right - no strenuous exercise the day before and the morning of the scan. This instruction has been down to the level of "don't even talk or walk around while waiting for the isotope to travel around". This is because any movement or inflammation will cause your muscles to to "take up" the contrast. So less easy to get clear images.

Here's hoping that "NOTHING" shows up on the scan.
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June 2002 extensive hi grade DCIS (pre-cancer-stage 0, clean sentinal node) Mastectomy/implant - no chemo, rads. "cured?"
9/2004 Diag: Stage IV extensive liver mets (!) ER/PR- Her2+++
10/04-3/05 Weekly Taxol/Carboplatin/Herceptin , complete response!
04/05 - 4/07 Herception every 3 wks, Continue NED
04/07 - recurrence to liver - 2 spots, starting tykerb/avastin trial
06/07 8/07 10/07 Scans show stable, continue on Tykerb/Avastin
01/08 Progression in liver
02/08 Begin (TDM1) trial
08/08 NED! It's Working! Continue on TDM1
02/09 Continue NED
02/10 Continue NED. 5/10 9/10 Scans NED 10/10 Scans NED
12/10 Scans not clear....4/11 Scans suggest progression 6/11 progression confirmed in liver
07/11 - 11/11 Herceptin/Xeloda -not working:(
12/11 Begin MM302 Phase I trial - bust:(
03/12 3rd times the charm? AKT trial

5/12 Scan shows reduction! 7/12 More reduction!!!!
8/12 Whoops...progression...trying for Perjeta/Herceptin (plus some more nasty chemo!)
9/12 Start Perjeta/Herceptin, chemo on hold due to infection/wound in leg, added on cycle 2 &3
11/12 Poops! progression in liver, Stop Perjeta/Taxo/Herc
11/12 Navelbine/Herce[ptin - try for a 3 cycles, no go.
2/13 Gemzar/Carbo/Herceptin - no go.
3/13 TACE procedure
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Old 08-23-2007, 12:34 AM   #7
hutchibk
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You need to call the radiology center and tell them to send you or email you EXACT instructions as to diet and timing of meals before the PET. The reason is that you cannot have extra glucose/sugar/sugar producing carbs for 24 hours before the test. The PET is a glucose uptake test, and you want it to be as accurate as possible. Insist upon them giving you written instructions. I find it pretty unbelievable that they didn't give you more info than that.

Yes, I always have to drink about a quart of water before my PET/CT. I always drink a 33 oz bottle of water on the drive there.


Here's some basic helpful info I found online...

Do not eat for at least 4 hours prior:
We recommend that you have nothing to eat or drink for at least 4 hours prior to your test . You may drink water up to 2 hours before your test. Please take all your usual medications.

Diabetic patients will be scheduled at times that will not interfere with their meds and meals. Drink water:

You are encouraged to drink 3-4 glasses of water prior to arriving at Redwood Regional Medical Group

High Protein Diet for 24 hours prior to study:
Beginning with breakfast the day before the study, eat a low carbohydrate, high protein diet before your study. Examples include meats, fish, vegetables, and salads. Do not eat pasta, bread, potatoes, or sugar.
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Brenda

NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

"I would rather be anecdotally alive than statistically dead."
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Old 08-23-2007, 05:08 AM   #8
Carolyns
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I didn't read this (sorry if I missed it), I have been told no coffee for 24 hours prior to the PET CT.

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Old 08-23-2007, 08:08 AM   #9
hutchibk
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yes, me too. I think for at least 12 hours ahead I have always been told to err towards clear liquids only, and no caffeine, sodas or juices (juice has too much natural sugar, soda of course is caffeine and sugar) - so I stick to water and de-caf unsweetenec iced tea.
__________________
Brenda

NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

"I would rather be anecdotally alive than statistically dead."
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Old 08-25-2007, 10:47 PM   #10
DonnaNY
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Thank you all for the info. I will let you know how my mom does. God Bless all !



Donna
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