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What should I expect with this PET scan Monday?

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Prostate Cancer
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Posted 3/30/2013 3:35 PM (GMT 0)
I have to be at the Heart Center at Spartanburg Regional by 1130 Monday, test to begin at Noon.  The scheduling person called me Friday, said nothing to eat after midnight, no jewelry, drink lots and lots of water.

She said the whole  thing takes 2 1/2 hours, of which 1 1/2 hours sitting in a recliner with an IV with a slow drip infusion of some isotope.  She did not know what was being put in.  Then I would be taken to the machine, and she said it would take 1 hour.

What am I missing here?  What are the typical isotopes used?  The order says "whole body", so I am taking that part literally.  I understand this is a radioactive isotope of some sort?  My doctor was somewhat reluctant in the past about the PET because of my heavy radiation exposure and damage.  Is this risky at all?

I have had endless MRI, CAT, bone scans, ultrasounds, etc, but never a PET, want to know what I am getting into.  Can't find anyone to ride with me, it will be a 100 mile round trip approx. from where I live.

david

Posted 3/30/2013 4:14 PM (GMT 0)
David,

It's comparable to having a CT followed by a regular bone scan all at the same time.

You will be injected, wait an hour, and then begin. Takes about an hour and you will move back and forth several times.

Not really a big deal. More time consuming than anything.

Jerry
Posted 3/30/2013 4:22 PM (GMT 0)
David, the water is important...before and after...as it helps to flush the stuff out of your kidneys. When John had a CT scan followed immediately by a bone scan, the nurse was very clear about the importance of drinking, drinking, drinking. Perhaps bring an extra bag to collect the urine in?

Never having had a PET scan, I have known several people who had one. And yes the stuff they inject is radioactive, hence the need for water to flush the kidneys. While I understand the concern over the additional exposure to radiation, not having the PET scan would be more dangerous than having it since you and your doctor need to know what is going on. Jerry's analogy of a CT scan coupled with a bone scan is accurate as the PET scan will show the organs as well as the entire bone structure.

A radiologist will read the test results...don't know if they will do that right there or after you leave. Then, the results of the test should be sent to your oncologist. I imagine it won't take long at all to get the results so hopefully sometime next week you should hear.

Here's hoping
Posted 3/30/2013 4:23 PM (GMT 0)
Is the tube enclosed...like the MRI or is it opened. Gotta admit I felt like I was in a coffin on my 45 minute MRI....real tight too and started feeling a little claustrophobic. I get my PET on the 4th.....
Posted 3/30/2013 4:40 PM (GMT 0)
Not as enclosed as a MRI...don't care much for MRIs and this is a lot better...more along the lines of a reg bone scan...
Posted 3/30/2013 5:17 PM (GMT 0)
david,

The most typical kind of PET scan uses a radioactive tracer called FDG (F18 -fluorodeoxyglucose), which, like glucose, is taken up rapidly by quickly dividing cells like cancer. Some of it is excreted while still radioactive in the urine within a couple of hours, and most of it decays naturally into harmless substances in the body. Its half-life is about 2 hours, which means that it's virtually all non-radioactive within a day.

The scanner itself is a narrow ring or doughnut that you are passed through while lying on a bench. It detects radioactive particles called positrons (positively charged electrons) that are generated in pairs as the F18 decays and are emitted in opposite directions.It detects the positrons in each slice as you pass through it, and the images are put together into a 3-D picture.

While the radiation dose to you from the PET scan itself is moderate (about 500 mrem), it is often combined with a full body CT scan, which delivers a hefty dose (about 2000 mrem). That's about the maximum occupational exposure allowed for nuclear industry workers for a year, so you don't want to make a habit out of getting these, but an occasional one won't do much harm.

There are other radioisotopes used for PET scans that seem to be better at detecting prostate cancers specifically at earlier stages of the disease. Because prostate cancer cells, at least in early stages, have a relatively low metabolic rate compared to other cancers, researchers have searched for molecules other than glucose to use. Also, because FDG is excreted in the urine, it masks any cancer in the kidney, bladder, and urethra (and the prostate if you still have one). The molecules they're using lately, like choline and acetate, are involved in lipid metabolism rather than glucose metabolism. NaF18 and F18-Choline are now more widely available. Because the fluorine atom (F18) can affect the molecule's metabolism, they've tried to use radioactive carbon (C11) instead. But C11 has a half-life of only 20 minutes, so it has to be made right there and can't be transported. C11 Choline and C11 Acetate PETs are available at only a very few places.

- Allen
Posted 3/30/2013 5:53 PM (GMT 0)
harold has had 6 or so pet scans because of his lymphome and will have another one in may. he can't eat or drink anything for at least 6 hourse before the scan. they give him 3 galsses of, as he calls it, disgusting white stuff, to drink. this is the radio isotope. after that he has to remain quiet and mostly motionless in a darkened room for an hour or so (to decrease brain activity). then they do the scan which takes another 45 minutes to an hour. harold's doc usually emails us the results the next day and then we go to see him a few days later to discuss the findings. so far, all his scans have been clean (no lymphoma) but the last one showed "suspicious activity" in the prostate area which we expected since harold had just had his biopsy.
expect a long, boring day!
Posted 3/30/2013 6:56 PM (GMT 0)
David, looks like you have received some really good answers on the contrast agent. As you know I have had 5 of the F18 scans in the last 1.5 years. The agent is radioactive. The first time I had it the tech asked if I would be near any airport scanners in the next 48 hours. If so, they had to give me a letter for TSA. I had the injections and then just had to wait for an 1-1.5 hour to give them a chance to circulate.

But beyond that the scan itself is very easy to tolerate.

The bigger answer to what you should expect is MAYBE SOME ANSWERS. That is what you should focus on. The rest is all just the mechanics of getting them.

Good luck,

Sonny
Posted 3/30/2013 9:20 PM (GMT 0)
Tall-   liked your total explanations on this stuff, I knew I liked your incite the minute you joined Healingwell, if I have any decent questions I will post them and ask for your reply, specifically and with others too.  Your researching and info on all this stuff is top drawer especially from a layperson.  No I don't expect you to mail me a check (lol).

Sonny- has plenty of experience in having done this

Purg- best to your experience with this, we all know you don't need any of Murphy's Laws in your life, so hope all is decent for you

Posted 3/30/2013 10:23 PM (GMT 0)
David, my wife gets a CT scan every 6 months for a 2 year to make sure here tumor is not back. She is always told to drink a lot of liquid before and after. This allows her body to flush out the isotope that they inject in her.
Posted 3/30/2013 10:45 PM (GMT 0)
Wow, I came home to some good answers.

tall allen - thanks for the detail, I am a detail kind of guy. the woman that called simply didn't know the intended agent or isotope to be used.

yes, my doctor hesitated in the past, because of his concern for my radiation exposure on top of all my extreme radiation damage. but even he wants some kind of assurance that there aren't any mets hidden away. this scan is still no absolute guarantee of finding evidence, but at this scan center its suppose to be the latest and bestest of machine. he feels the risk is worth it, if we are going to continue our current plan of watching or "observation". I back what he is thinking, I too want to make sure its safe to continue this course.

It will be an IV, no problem for me, and said 1 1/2 hours in a recliner, and then about an hour in the machine. I have had so many MRI's done, both closed and open, not a problem for me about that aspect, I just close my eyes, hold still like a corpse, and chill into some distant zone in my mind. Have gotten good at that.

Sonny, yep, I know you have been through this, and we talked about it way back then, and even my doctor was ok, but things just kept getting put on the back burner.

Hopefully it will be a piece of cake and no snags.

Right now, the likelihood of CRPS being diagnosed by another doctor seems more likely than this scan showing up anything significant. Hoping that is the case. It's amazing how this pain is spreading more and more through my body with no improvements. There has to be a medical reason, its not natural for this to be happening.

thanks for the great replies,

david
Posted 3/30/2013 10:54 PM (GMT 0)
Zufus- does that mean you only take cash? ;-)

I try hard to translate medical and scientific jargon into plain English, although I recognize that something is always lost in translation. I get to practice on the guys in my PC support group who come from all walks of life. It can be very scary to not fully understand what doctors are talking about and doing to your body. Doctors can't or won't always take the time, which is why these forums can be so valuable.
Posted 3/31/2013 12:46 AM (GMT 0)
David,

I also remember them telling me to try to not eat bread and sugary foods the day before.

Jerry
Posted 3/31/2013 1:12 AM (GMT 0)
jerry,

all they said was no eating after midnight, and keep drinking all the water I can stand ahead of time, but nothing but water. won't bother me, I never eat breakfast, and I rarely drink anything except for water.

david
Posted 3/31/2013 10:40 PM (GMT 0)
Tall Allen,

Thank you for that very detailed reply!

You, along with others, are truly an asset to this board.

Thanks again for taking time to explain this.
Posted 3/31/2013 11:23 PM (GMT 0)
Already not going to eat any more today, just came back from big Easter dinner spread at my oldest son's house. Be glad to have this test behind me.
Posted 4/1/2013 12:04 AM (GMT 0)
David,

Nothing but a thing. Just a lot of hurry up and wait. Last time I had to wait for the radioactive material to arrive. It will be over before you know it and then you can grab something to eat.

Hang in there...

JL
Posted 4/1/2013 1:02 AM (GMT 0)
yeah, jerry, with my general lack of appetite, not worried about eating, never eat breakfast, and only have lunch if I am at a biz meeting.
Posted 4/1/2013 2:06 PM (GMT 0)
Well, I am out the front door, and heading to Spartanburg for the test. A little uptight, but mostly about the driving part and the traffic ahead. Hope to be glowing soon.

david
Posted 4/1/2013 7:21 PM (GMT 0)
Here's hoping you send us a glowing report when you get home...
Posted 4/1/2013 10:41 PM (GMT 0)
Best of luck David.
Posted 4/1/2013 10:45 PM (GMT 0)
David,

I think you have had your procedure (PET SCAN) by now?. It wasn't too bad afterall I trust.
Now here's hoping for some kind of an answer to your mystery.

Thinking of you!

BOOGEE
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