Today at 11:30 I need to go the the AMC. Another, bigger, hospital here in Amsterdam that has the PET scan facilities. Theo is still 6 by 4 centimeters and with the scan they are going to see how active he is. I dont have an appointment yet to discus the outcome but expect that that will be in a week and a half.
Wanna know what a PET scan is?
PET stands for Positron emission tomography and is a nuclear medicine imaging technique which produces a three-dimensional image or map of functional processes in the body. The system detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide (tracer), which is introduced into the body on a biologically active molecule. Images of tracer concentration in 3-dimensional space within the body are then reconstructed by computer analysis. (from wikipedia)
Based on the outcome the oncologist will determine what further treatment i will need according to him. This could either be:
- – surgery (to cut the remaining theo tissue out)
- – radiation (to kill it as with chemo)
- – or to do nothing (and let the body take care of theo).
I am all for the last one 😎 But what ever is needed will get done. Annoying part is that determining what to do at this stage is not an exact science. Its not the same as when I started, then the answer was clear: BEP chemo. Now it wont be as clear. I expect to need a second opinion and do a lot of talking and understanding.
So from what i understand the procedure involves a lot of relaxation. I need to go in sober (thats why i am distracting my self with blogging and not think about eating….really). At the hospital i will be put in a bed and will get an IV. Through the IV I will get the specific (radioactive) tracer. Some how this tracer is linked to my glucose-whatever so no sugar and i need to lay still for at least 30 minutes before the can start the scan. My iphone is loaded up with video and music. The whole procedure takes up like two hours. Sometimes you get valium to relax. This is what wikipedia says about it:
Oncology: PET scanning with the tracer fluorine-18 (F-18) fluorodeoxyglucose (FDG), called FDG-PET, is widely used in clinical oncology. This tracer is a glucose analog that is taken up by glucose-using cells and phosphorylated by hexokinase (whose mitochondrial form is greatly elevated in rapidly-growing malignant tumours). A typical dose of FDG used in an oncological scan is 200-400 MBq for an adult human. Because the oxygen atom which is replaced by F-18 to generate FDG is required for the next step in glucose metabolism in all cells, no further reactions occur in FDG. Furthermore, most tissues (with the notable exception of liver and kidneys) cannot remove the phosphate added by hexokinase. This means that FDG is trapped in any cell which takes it up, until it decays, since phosphorylated sugars, due to their ionic charge, cannot exit from the cell. This results in intense radiolabeling of tissues with high glucose uptake, such as the brain, the liver, and most cancers. As a result, FDG-PET can be used for diagnosis, staging, and monitoring treatment of cancers, particularly in Hodgkin’s disease, non Hodgkin’s lymphoma, and lung cancer. Many other types of solid tumors will be found to be very highly labeled on a case-by-case basis– a fact which becomes especially useful in searching for tumor metastasis, or for recurrence after a known highly-active primary tumor is removed. Because individual PET scans are more expensive than “conventional” imaging with computed tomography (CT) and magnetic resonance imaging (MRI), expansion of FDG-PET in cost-constrained health services will depend on proper health technology assessment; this problem is a difficult one because structural and functional imaging often cannot be directly compared, as they provide different information. Oncology scans using FDG make up over 90% of all PET scans in current practice.