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Old 02-17-2017, 06:04 AM   #1
TiffanyS
Senior Member
 
Join Date: Sep 2016
Posts: 290
CT scan vs PET scan

A lot of you on this site seem to get PET scans instead of CT scans. At least that seems to be the norm with the Americans. In Canada, I don’t qualify for a PET scan (although I’ve never been told why, even though I’ve asked), so, I’m thinking of paying for it myself. Based on what I’ve read, a PET scan lights up all cancer cells in your body, can tell the difference between normal and tumor cells in your body and can indicate the stage and aggressiveness of your cancer. I also read that a PET scan can show whether scar tissue is active cancer or not. This is the main reason I want the PET scan, to see if the pimples on my chest wall are scar tissue, which is what my doctor thinks, or cancer. I am hesitant to believe my doctor because before my recurrence they told me the pimples on my chest wall were scar tissue, and they turned out to be cancer. My doctor doesn’t want to biopsy the area, and says that the chest CT scan I have scheduled for mid-March will only show her what’s there, but not whether it’s cancer or not. She said the same thing about an ultrasound or MRI. Since none of these test can determine if my “scar tissue” is in fact scar tissue, and my doctor doesn’t want to biopsy the area, I think that a PET scan is my best alternative. I don’t know the exact cost, but I’ve been told that it’s around $1,500 in my province. I’m just wondering if it’s worth paying the money for a PET scan, and would like advice from those of you who have had frequent scans? Do you know if a PET scan will be able to give me the information I want? I really want to know if I have another cancer recurrence, as this means I’m not responding to my current treatment plan, however, my doctor doesn’t seem to feel the same way. I don’t like her “let’s wait and see” attitude. I’ve also heard of a PET/CT scan, and am wondering if this is a method that combines the two scans, and, if so, if this is better than just a PET scan?


12/15 – First mammogram
01/16 – Second mammogram and ultrasound.
01/16 – Meet surgeon and go for third mammogram, second ultrasound and biopsy. Surgeon confirms cancer in left breast and lymph nodes and sets surgery date.
01/16 – Chest scan and bone scan done– all looks good.
02/16 – Surgery - left breast mastectomy and 16 lymph nodes removed (8 had cancer).
02/16 – CT scan done – small nodules on lung but Doctor advises it’s post surgical. They will continue to monitor just in case.
03/16 – Meet radiation oncologist and find out results of Pathology Report. I’m told that I have locally advanced breast cancer, based on the size of my tumour (7 cm!) and the fact that they found cancer cells in eight lymph nodes. I’m also told that I’m HER 2 positive, with high levels of estrogen and progesterone and that my cancer is stage 3, grade 2.
03/16 – Meet oncologist and am told that my cancer is actually grade 3, and that I should have done chemo before surgery. Too late now!
03/16 – Start first of six doses of chemo (Carboplatin and Docetaxal) and Herceptin (for 18 months).
04/16 – Have port put in.
04/16 – Get second dose of chemo, but Docetaxal is left out due to liver enzymes being high. I was unable to get a full dose of Docetaxal after my first treatment.
06/16 – Finished chemo! One month off and then I start radiation.
06/16 – Start Tamoxifen.
07/16 – First radiation treatment – 24 more to go!
08/16 – Went for Genetic Testing to see if I have the BRCA gene. Tested negative for BRCA I and II
08/16 – Radiation oncologist biopsies “scar tissue” on my chest wall. I am told that I have a local recurrence and need to have rush surgery.
09/16 – Meet surgeon who advises that I need to meet with a plastic surgeon, as they will need to do a skin graft to close me up after surgery. Meet plastic surgeon and all looks good. A surgery date is set for October 4.
09/16 – Go for rush ultrasound, bone scan, breast MRI and CT scan.
09/16 – Meet oncologist who advises that the ultrasound and bone scan results look good, and that MRI shows three small masses at surgery site, but lymph nodes are clear. Still awaiting the results of the CT scan, but we are positive it will look good.
09/16 – Get a call from my oncologist, who advises that CT scan shows small spots on my lungs, and a large lymph node in the middle of my chest. This means the cancer has spread! She looks into getting me funded for TDM-1 and cancels my surgery.
10/16 – Meet oncologist, who advises that I have to take Perjeta before I can take TDM1. I start Perjeta/Herceptin every three weeks for an indefinite amount of time, and Taxol, which I will take two weeks in a row with one week off and then two weeks in a row for 8-16 treatments. Stop Tamoxifen.
10/16 – Meet surgeon, who reviews my CT scan and advises that the spots on my lungs may not be cancer, and that he doesn’t see a lymph node in my chest. He thinks it’s a spot on my lung. I’m feeling very confused! He advises that my oncologist doesn’t want me to have surgery to remove the three small masses on my scar line, as she wants to use them as a way to determine if the treatment is working. He advises that if they have not shrunk in 6 months, he will revisit surgery.
10/16 – CEA blood test to determine Tumour markers. Results were normal (2.7). My doctor advises that this could mean two things: (1) that the treatment is working, and the tumours are shrinking, or (2), that I'm one of those people who never get elevated CEA levels. Given that some people never get an elevated CEA level, this test doesn’t seem very accurate to me! Asked for PET scan, but am told I don’t qualify.
10/16 – Brain MRI – NED!
11/16 - CA-15-30 blood test – Tumour markers are normal at 19.
11/16 – Second CEA blood test – Tumours markers are still normal at 1.6
11/16 – Second CA-15-30 bloot test – Tumour markers are still normal at 19
11/16 – Develop lymphedema and have to wear a sleeve
12/16 – CT Scan shows that the tumors on my lungs and the lymph node in the middle of my chest are shrinking, and that some have resolved. Also, the small masses along my scar line are no longer visible. This means the medication is working!
12/16 – Small “pimple” shows up where old tumour on chest wall was located. Doctor is going to monitor it for now.
01/17 – A second “pimple” shows up on chest wall, as well as a small lump under the skin. My doctor thinks it’s scar tissue and will monitor it for now.
03/17 – CT Chest scan scheduled to see if there’s improvement to chest and lungs. If results the are good, I get to stop taking Taxol!
03/17 – Second brain MRI scheduled
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Old 02-17-2017, 12:05 PM   #2
supportwife
Senior Member
 
Join Date: Oct 2014
Posts: 34
Re: CT scan vs PET scan

Here in America and we have been to two premium university hospitals, they have never done PET scan for my wife. They did it only once for radiation planning. The doctors are very comfortable with CT or MRI. We have been told the CT scan with contrast resolution is pretty effective.

Hope this helps.
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Old 02-17-2017, 12:45 PM   #3
TiffanyS
Senior Member
 
Join Date: Sep 2016
Posts: 290
Re: CT scan vs PET scan

We don’t have many PET scanning machines in Canada, however, we have three public machines and two privately funded machines close to where I live. Doctors don’t send people for PET scans often here, however, I think a PET scan will give me the information I’m looking for better than a CT scan. In fact, my doctor’s already told me that my next CT chest scan will see the “scar tissue” but, they won’t be able to determine if it’s cancer or not based on the scan. I really want a PET scan, even if it’s for piece of mind.


12/15 – First mammogram
01/16 – Second mammogram and ultrasound.
01/16 – Meet surgeon and go for third mammogram, second ultrasound and biopsy. Surgeon confirms cancer in left breast and lymph nodes and sets surgery date.
01/16 – Chest scan and bone scan done– all looks good.
02/16 – Surgery - left breast mastectomy and 16 lymph nodes removed (8 had cancer).
02/16 – CT scan done – small nodules on lung but Doctor advises it’s post surgical. They will continue to monitor just in case.
03/16 – Meet radiation oncologist and find out results of Pathology Report. I’m told that I have locally advanced breast cancer, based on the size of my tumour (7 cm!) and the fact that they found cancer cells in eight lymph nodes. I’m also told that I’m HER 2 positive, with high levels of estrogen and progesterone and that my cancer is stage 3, grade 2.
03/16 – Meet oncologist and am told that my cancer is actually grade 3, and that I should have done chemo before surgery. Too late now!
03/16 – Start first of six doses of chemo (Carboplatin and Docetaxal) and Herceptin (for 18 months).
04/16 – Have port put in.
04/16 – Get second dose of chemo, but Docetaxal is left out due to liver enzymes being high. I was unable to get a full dose of Docetaxal after my first treatment.
06/16 – Finished chemo! One month off and then I start radiation.
06/16 – Start Tamoxifen.
07/16 – First radiation treatment – 24 more to go!
08/16 – Went for Genetic Testing to see if I have the BRCA gene. Tested negative for BRCA I and II
08/16 – Radiation oncologist biopsies “scar tissue” on my chest wall. I am told that I have a local recurrence and need to have rush surgery.
09/16 – Meet surgeon who advises that I need to meet with a plastic surgeon, as they will need to do a skin graft to close me up after surgery. Meet plastic surgeon and all looks good. A surgery date is set for October 4.
09/16 – Go for rush ultrasound, bone scan, breast MRI and CT scan.
09/16 – Meet oncologist who advises that the ultrasound and bone scan results look good, and that MRI shows three small masses at surgery site, but lymph nodes are clear. Still awaiting the results of the CT scan, but we are positive it will look good.
09/16 – Get a call from my oncologist, who advises that CT scan shows small spots on my lungs, and a large lymph node in the middle of my chest. This means the cancer has spread! She looks into getting me funded for TDM-1 and cancels my surgery.
10/16 – Meet oncologist, who advises that I have to take Perjeta before I can take TDM1. I start Perjeta/Herceptin every three weeks for an indefinite amount of time, and Taxol, which I will take two weeks in a row with one week off and then two weeks in a row for 8-16 treatments. Stop Tamoxifen.
10/16 – Meet surgeon, who reviews my CT scan and advises that the spots on my lungs may not be cancer, and that he doesn’t see a lymph node in my chest. He thinks it’s a spot on my lung. I’m feeling very confused! He advises that my oncologist doesn’t want me to have surgery to remove the three small masses on my scar line, as she wants to use them as a way to determine if the treatment is working. He advises that if they have not shrunk in 6 months, he will revisit surgery.
10/16 – CEA blood test to determine Tumour markers. Results were normal (2.7). My doctor advises that this could mean two things: (1) that the treatment is working, and the tumours are shrinking, or (2), that I'm one of those people who never get elevated CEA levels. Given that some people never get an elevated CEA level, this test doesn’t seem very accurate to me! Asked for PET scan, but am told I don’t qualify.
10/16 – Brain MRI – NED!
11/16 - CA-15-30 blood test – Tumour markers are normal at 19.
11/16 – Second CEA blood test – Tumours markers are still normal at 1.6
11/16 – Second CA-15-30 bloot test – Tumour markers are still normal at 19
11/16 – Develop lymphedema and have to wear a sleeve
12/16 – CT Scan shows that the tumors on my lungs and the lymph node in the middle of my chest are shrinking, and that some have resolved. Also, the small masses along my scar line are no longer visible. This means the medication is working!
12/16 – Small “pimple” shows up where old tumour on chest wall was located. Doctor is going to monitor it for now.
01/17 – A second “pimple” shows up on chest wall, as well as a small lump under the skin. My doctor thinks it’s scar tissue and will monitor it for now.
03/17 – CT Chest scan scheduled to see if there’s improvement to chest and lungs. If results the are good, I get to stop taking Taxol!
03/17 – Second brain MRI scheduled
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Old 02-17-2017, 01:11 PM   #4
Spring
Junior Member
 
Join Date: Feb 2017
Posts: 2
Re: CT scan vs PET scan

Can you do a biopsy? For my small lung nodules, PET SCAN picked up the cancer activitieis, but I have read also there is no guarantee of the detection if lung nodules are too small or not avid.
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Old 02-17-2017, 01:28 PM   #5
TiffanyS
Senior Member
 
Join Date: Sep 2016
Posts: 290
Re: CT scan vs PET scan

My doctor doesn’t want to do a biopsy, because the pimples are too small to use a needle, so they’d have to cut them off. She doesn’t want to do that because she doesn’t want to risk an infection or, if it is cancer, spreading the cancer, which she says cutting it off could do. We can also feel a small lump under the skin, which she also thinks is scar tissue, but, for some reason, she doesn’t want to use a needle to biopsy it. We actually had a bit of an argument over this a few weeks ago, because I really want to know for sure if these pimples are cancer or scar tissue, and she doesn’t seem that concerned. She’s more concerned with the cancer in my lungs and chest, and, since the medication seems to be working in regard that cancer, she wants to stay on course, and just monitor the pimples and lump on my chest wall for now.


12/15 – First mammogram
01/16 – Second mammogram and ultrasound.
01/16 – Meet surgeon and go for third mammogram, second ultrasound and biopsy. Surgeon confirms cancer in left breast and lymph nodes and sets surgery date.
01/16 – Chest scan and bone scan done– all looks good.
02/16 – Surgery - left breast mastectomy and 16 lymph nodes removed (8 had cancer).
02/16 – CT scan done – small nodules on lung but Doctor advises it’s post surgical. They will continue to monitor just in case.
03/16 – Meet radiation oncologist and find out results of Pathology Report. I’m told that I have locally advanced breast cancer, based on the size of my tumour (7 cm!) and the fact that they found cancer cells in eight lymph nodes. I’m also told that I’m HER 2 positive, with high levels of estrogen and progesterone and that my cancer is stage 3, grade 2.
03/16 – Meet oncologist and am told that my cancer is actually grade 3, and that I should have done chemo before surgery. Too late now!
03/16 – Start first of six doses of chemo (Carboplatin and Docetaxal) and Herceptin (for 18 months).
04/16 – Have port put in.
04/16 – Get second dose of chemo, but Docetaxal is left out due to liver enzymes being high. I was unable to get a full dose of Docetaxal after my first treatment.
06/16 – Finished chemo! One month off and then I start radiation.
06/16 – Start Tamoxifen.
07/16 – First radiation treatment – 24 more to go!
08/16 – Went for Genetic Testing to see if I have the BRCA gene. Tested negative for BRCA I and II
08/16 – Radiation oncologist biopsies “scar tissue” on my chest wall. I am told that I have a local recurrence and need to have rush surgery.
09/16 – Meet surgeon who advises that I need to meet with a plastic surgeon, as they will need to do a skin graft to close me up after surgery. Meet plastic surgeon and all looks good. A surgery date is set for October 4.
09/16 – Go for rush ultrasound, bone scan, breast MRI and CT scan.
09/16 – Meet oncologist who advises that the ultrasound and bone scan results look good, and that MRI shows three small masses at surgery site, but lymph nodes are clear. Still awaiting the results of the CT scan, but we are positive it will look good.
09/16 – Get a call from my oncologist, who advises that CT scan shows small spots on my lungs, and a large lymph node in the middle of my chest. This means the cancer has spread! She looks into getting me funded for TDM-1 and cancels my surgery.
10/16 – Meet oncologist, who advises that I have to take Perjeta before I can take TDM1. I start Perjeta/Herceptin every three weeks for an indefinite amount of time, and Taxol, which I will take two weeks in a row with one week off and then two weeks in a row for 8-16 treatments. Stop Tamoxifen.
10/16 – Meet surgeon, who reviews my CT scan and advises that the spots on my lungs may not be cancer, and that he doesn’t see a lymph node in my chest. He thinks it’s a spot on my lung. I’m feeling very confused! He advises that my oncologist doesn’t want me to have surgery to remove the three small masses on my scar line, as she wants to use them as a way to determine if the treatment is working. He advises that if they have not shrunk in 6 months, he will revisit surgery.
10/16 – CEA blood test to determine Tumour markers. Results were normal (2.7). My doctor advises that this could mean two things: (1) that the treatment is working, and the tumours are shrinking, or (2), that I'm one of those people who never get elevated CEA levels. Given that some people never get an elevated CEA level, this test doesn’t seem very accurate to me! Asked for PET scan, but am told I don’t qualify.
10/16 – Brain MRI – NED!
11/16 - CA-15-30 blood test – Tumour markers are normal at 19.
11/16 – Second CEA blood test – Tumours markers are still normal at 1.6
11/16 – Second CA-15-30 bloot test – Tumour markers are still normal at 19
11/16 – Develop lymphedema and have to wear a sleeve
12/16 – CT Scan shows that the tumors on my lungs and the lymph node in the middle of my chest are shrinking, and that some have resolved. Also, the small masses along my scar line are no longer visible. This means the medication is working!
12/16 – Small “pimple” shows up where old tumour on chest wall was located. Doctor is going to monitor it for now.
01/17 – A second “pimple” shows up on chest wall, as well as a small lump under the skin. My doctor thinks it’s scar tissue and will monitor it for now.
03/17 – CT Chest scan scheduled to see if there’s improvement to chest and lungs. If results the are good, I get to stop taking Taxol!
03/17 – Second brain MRI scheduled
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Old 02-17-2017, 04:33 PM   #6
Juls
Senior Member
 
Join Date: Mar 2014
Location: UK
Posts: 365
Re: CT scan vs PET scan

Hi Tiffany
Just reading your post. I've often wondered about the difference between Ct & Pet scans.
We only get offered Ct (or if required MRI) here. Thought one reason was that they were not widely available. So thought I'd look up hospitals that have Pet scans in Scotland. Well - what a surprise - only 2 listed and 1 is in the hospital I attend! They kept that quiet!!
Mind you, not sure if I want to know any more at the moment!
The private hospital I went to for Ct's last year had just installed a new CT scanner that they said was accurate to a few mm's. Didn't help me much - they missed bone met for a year over 4 CT's! Recent scans have been in a much older machine. If I get on this new trial I will be sent back to private hospital again. Maybe I should ask for a pet scan if they suggest MRI. (Not keen on MRI after my experience a few years ago. )

Also just read that when scanned - position ( wider or narrower slices) never exactly the same from ct to ct & it can make things look bigger or smaller. So much for accuracy!

Re the cost here - on average 900 for Pet and 500 for CT. MRI about 475 privately.
This surprises me - thought MRI the most expensive!

Geez - the things you find out!!

Juls
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Old Yesterday, 06:56 AM   #7
thinkpositive
Senior Member
 
Join Date: May 2014
Location: San Diego
Posts: 383
Re: CT scan vs PET scan

Tiffany,

A PET scan cannot determine if cells are cancerous or not. The PET will show areas that "light up" as a result of the liquid you ingest prior to the procedure. I believe this liquid is glucose but I'm not sure. The areas that "light up" are given a SUV rating. My understanding is that the higher the SUV rating, the more likely that there is cancer in the area. Know that things can "light up" and have a high SUV rating and still not be cancer. I had a mass in my uterous that light up and was told that it was likely cancer. It turned out to be something else (thank goodness).

I don't know if a PET scan could pick up something as small as a pimple. Something to think about before pursuing self paying for this test.

Take Care,
Brenda
__________________
8/2013 Diagnosed IDC Left Breast ER-/PR-/HER2+ Stage 3C, DCIS ER+/PR+/HER2- Right Breast (54 yr)
8/2013 PET/CT scan shows mass in uterues and suprclavicular nodes
8/20/13 Begin 6 rounds TCH chemo, Perjeta added for rounds 4-6
9/2013 After 1st round of chemo, mass in neck and breast no longer able to feel
11/2013 Hysterectomy, mass from PET/CT scan not cancer (adenomylosis)
12/2013 Finished chemo
1/2014 Double mastectomy with chest expanders
1/2014 Pathology report from surgery and SNB show complete pathological response!
3/2014 Finish IMRT radiation
8/2014 Fat transfer to radiated breast
8/2014 Completed 1 yr of Herceptin
10/2014 exchange surgery expanders removed implants placed
6/2015 3D nipple and areola tattoos
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Old Yesterday, 11:26 AM   #8
Mtngrl
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Join Date: May 2011
Location: Denver, CO
Posts: 1,354
Re: CT scan vs PET scan

I get a combined PET/CT. The PET shows areas that are "glucose avid." The CT gives a picture of the shape and size of the thing, but, as Tiffany says, can't detect whether it's metabolically active or not. But if you've got a known cancerous tumor and it's smaller (or gone) on the CT scan you know you have a therapeutic response.

The PET detects inflammation. Cancer is an inflammatory process, and since they know I have cancer it's pretty safe to assume that areas of increased FDG uptake on a PET scan are cancerous. But other things also cause inflammation. I've had pneumonia, bronchitis, and radiation pneumonitis recently. All those areas would be FDG avid too, as would sore muscles from doing strenuous exercise.

I was taught that it's not accurate to make comparisons of readings between scans. You might be on a different machine. Your base metabolic level might be different on the two dates.

The data you get from any kind of scan need to be interpreted in an educated manner, in context and in light of other data. It's part art and part science.

Amy
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