Brain PET tomorrow

[StephN]

Well gang, I am getting a little closer to finding out what, if anything, can be done for my Question Mark that showed up in my last brain MRI.
To recap, there is a little enlargement to the area of Gamma Knife one year ago in my cerebellum. This is after nine months of shrinkage.
So it was decided to try a PET scan of my brain to see if they can tell any more about what is going on before doing an actual open surgery.

If I am lucky, I will have results Friday. My docs are all in town this week!
One thing I did not know - no need for Atavan with the brain PET. Means I can drive myself and no one has to wait with me.

It will be a comfort to know that I have a lot of good energy and prayers coming from the wonderful people here.

[Lisa]

Steph,

Best of luck, sis. On my last PET scans, I asked for copies of the films on the spot and got them. If you think you could tell what you're looking at, you might give it a try. Of course, there were several spots on mine that were NOT mets, so it can make you a tad bit nervous.

Love and light,

Lisa

[AlaskaAngel]

Lots and lots of positive energy coming your way from Alaska, Steph, as you define what is going on and work your way forward with your doctors. Keep your eyes on the prize.

HUGS,

AlaskaAngel

[Becky]

Tons of good karma from the opposite coast is coming your way. I'll be thinking of you.


:) Becky

[Maryanne]

You will be in my thoughts and prayers tomorrow.
All the best,
Maryanne

[al from Canada]

Steph,

I will be thinking of you tomorrow. And, hoping for the best.

Good luck,
Al and Linda

[karenann]

My thoughts and prayers will be with you.

Love and hugs,
Karen

[Helen]

You will be in my thoughts and prayers.

Best wishes,
Helen

[RhondaH]

My thoughts and prayers are with you.

Rhonda

[Barbara H.]

Hi Steph,
You know that I will be thinking of you over the next few days. You will get through this. We will all be waiting with you for the results.
Best wishes,
Barbara H.

[eric]

Steph...sending only good thoughts your way! Eric

[Esther]

Steph hope you find the answers you need from this Petscan.

[Sandy H]

Wishing you well. I just know you will get to the bottom of this and then be on top once again. Sending you prayers, hugs, Sandy

[Lolly]

Steph, I'll be thinking of you tomorrow for sure, you've been a rock for all of us and now it's your turn to soak up all the good energy coming your way :) Hope you get the report SOON. I know you'll keep us posted.

<3 Lolly

[IRENE FROM TAMPA]

Steph

I am sending you one of my angels to watch over you - my prayers and best thoughts are with you today.

Good luck my friend

[michele u]

I'm thinking about you steph.

[mickey]

Wishing good news for you. What will a pet show that an mri won't? All my tumors have been confirmed with mri with no question of getting a pet. Am I missing an opportunity?

[Joe]

Stephanie,

Before surgical intervention, I would suggest a second opinion. I do know that Dr. Black's group in Los Angeles will review your MRI's for a $50.00 fee.

I am also confident that Christine's radiation oncologist here in San Diego would review your records and offer his opinion.

Regards
Joe

[LisaJ]

My thoughts and prayers are with you. Lots of good vibes!

[pattyz]

Mickey:
I believe the reason for pet is to determine active cancer or benign necrotic tissue. I do know there is an MRi/Pet type scan that can do this. Will include info here.
hugs,
pattyz

Performed together, MRI and MRS (magnetic resonance spectroscopy) produce an image of the brain that shows both morphology and tissue metabolism. Certain metabolites are present in greater or lesser quantities in tumors, compared to normal brain tissue. Choline is a cell-member marker that is found in increased quantities in malignant tumors.

BACKGROUND: There have been some reports that radiation necrosis can be controlled conservatively. There are rare cases showing progressive space-occupying radiation necrosis (PSORN). It is very difficult to control PSORN by conservative treatment. The purpose of this study was to evaluate the early diagnosis of those cases and the timing of surgery for patients with PSORN. METHOD: We have experienced some cases where quality of life was improved by the removal of PSORN after stereotactic radiosurgery (SRS) for brain metastases. Therefore, we evaluated retrospectively the diagnosis and treatment of six cases of symptomatic PSORN at approximately 6-12 months after SRS for metastatic brain tumours. FINDINGS: In all six cases, on Magnetic Resonance Imaging with Gd contrast material (Gd-MRI), PSORN was revealed as a ring-like enhanced mass with large perifocal oedema coupled with the appearance of neurological deficit. Proton Magnetic Resonance Spectroscopy ((1)H-MRS) enabled us to differentiate PSORN from recurrence of metastases in all six cases.

MRS Applications in Oncology
By Pia C. Sundgren MD, PhD, Suresh K. Mukherji MD
Lately, MRS has been shown to be a helpful tool in evaluation of a new contrast-enhancing lesion at the site of a previously identified and treated primary intracranial neoplasm, differentiating recurrent tumor from radiation injury.

Radiation injury versus recurrent brain tumor . Contrast-enhancing lesions that arise on routine brain MR imaging at the site of a previously identified and treated primary intracranial neoplasm present a significant diagnostic dilemma. These lesions are in regions that have been subjected to radiation, with or without chemotherapy, and in some instances surgical resection. Many do not have specific imaging characteristics that will enable the neuroradiologist to discriminate tumor recurrence from the inflammatory or necrotic changes that can result from treatment with radiation. 28 Both recurrent tumors and radiation injury typically demonstrate enhancement with gadolinium. Specific spectroscopic changes that occur with radiation-induced necrosis have been reported and include slight depression of NAA and variable changes in choline. 29-32 A recent study reported a 93% success rate in differentiating recurrent tumor from radiation injury with significantly increased Cho/NAA and Cho/Cr ratios (P < 0.001) in areas of recurrent tumor compared to areas of radiation injury and compared to normal adjacent brain tissue. 33 These results also are supported by previous work utilizing SVS, where the authors claim that a Cho/Cr ratio over 1.79 or lipid-lactate/Cho ratio less than 0.75 has a sevenfold increased odds of indicating tumor compared to pure necrosis.

[pattyz]

Steph,
Hope this test will do the 'trick' for you and show minimal rad damage rather than any activity of mets...

Another test for you to tuck away in your experience folder!

xoxoxoxoxoxoxthinking of you.
hugs,
pattyz

[brittd01]

Good luck Steph!!! I am thinking of you.


xoxo,
Brittany

[Kim in CA]

Oh Steph,

You know I feel like I'm sitting in the seat right next to you on this scary roller-coaster, and it's too late to get off now. We just have to hang on tight and give it all we've got. I know this is what you always do anyway! I'm thinking of you and praying my hardest. Love Kim

[tammymarie1971]

Thinking of you too Steph!
Tammy

[StephN]

To all of you who held me in their thoughts today.
What I actually had was a scan in the new PET/CT machine.
They scanned my neck and head.
That was the easiest thing I have done - just more like a long CT scan, without having to drink something beforehand. Both screenings are done in ONE machine and the PET part was perfectly quiet - not even a light blinking to tell me something was happening.

And the space inside is a little larger than the old PET scanner so I did not even feel the sides with my elbows. So if anyone is problematic with tight spaces this will be easier for you to tolerate.

Hope to have some results by the end of tomorrow - the radiologist I know was not attending today, so could not get a "sneek peek."

[sherri]

Dear Steph,
I wish you the best result possible and no matter what this will pass too. I was thinking about you all day.
Big hug,

[Sandy H]

I just know you will get to the bottom of this and then you will rise to the top. You will be in my prayers and good luck. Hugs, Sandy