Case 35: RADIOLOGIC ASSESSMENT

Discussant: CHAAN NG, MD (Dr Grothey Case)

A pdf file showing images from this case cancer be reviewed by clicking here. This large file may take some several minutes to upload to you.

Initial presentation, PET (done September 2006, first 15 images)

Markedly hypermetabolic nodular lesions appear in the liver, all in the right lobe on the top cuts, right up against the inferior vena cava (IVC). There is also a lesion in the left lobe and a few other peripheral ones. The most troublesome lesion is sitting by the IVC, in the caudate lobe. On a technical note, you can see a ghost of the liver, which is delineated in blue. Further out, you see a purple color. The reason for this is a misalignment. Basically the PET image and the CT image, which is in purple behind, have been misaligned.

Post-colectomy CT (done January 2007, images 16-22)

There is a lesion on the left and a lesion on the right, close to the IVC. A lesion in segment VIII is tucked up against the right hepatic vein, middle hepatic vein and IVC. Also, there is a metastasis on the caudate lobe. You could argue that the lesions look smaller, but you have to be careful because the edges on PET are fuzzy.

Post-Operative CT (done May 2007, images 23-26)

Here you can see signs that the patient underwent resection of the left and right lobes.

A set of slides is available relevant to this case. They can be viewed by clicking here.

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