Bone met or something else causing PET to light up? - 1266404

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teresa567
Bone met or something else causing PET to light up? - 1266404

Hi guys,

I'd really appreciate your thoughts. So my mom is roughly 3.5 years out after a wedge resection to her R middle lobe for a 1cm nodule that was negative on PET. One lymph node was additionally found positive upon resection and it was typed adenocarcinoma (KRAS mutation). She had follow up concurrent radiation and chemo (which were ROUGH for her), but since healing and a bout of radiation pneumonitis(sp?), things had been good since.

Then just this past August she had one her follow up CTs and an area looked a little questionable in the lower R lobe. They decided to wait a couple months (she was out-of-town) and she had a PET-CT to evaluate yesterday. The lung area on PET did not light up and doc felt confident it is not an issue at this time. (Makes me a little nervous considering her original positive mass never light up either...but I gotta have some faith here).

However, she had a spot in her spine around L5 (or L6?) that did light up on the PET (but nothing really showed on the CT in that area). The same spot had also lit up a mild amount on her PET last Jan., but this time it had more uptake (I don't know the uptake numbers). She's 72 and she has pretty bad kyphosis(sp?) and in general, far from fantastic posture. She complains of no pain in the spine, just some getting "older" aches and pains now and then. She's not a super active lady. Doc doesn't think this is cancer, but also mentioned it doesn't appear in the area where an arthritic change normally takes place (something about this uptake is located more in the middle rather than on the outside on L5 or L6 area...I can't recall exactly what was said). She is having an MRI done today of the spine.

If not cancer, what the heck else could this be? Also, thoughts on MRIs and detecting bone mets in the spine vs. using PET/CT? Feel a bit nervous and terrified (& doesn't help that I'm almost 8 months pregnant with my first kiddo...pregnancy hormones & cancer stuff togeth

JimC
Hi Teresa,

Hi Teresa,

PET scans are definitely more sensitive in detecting bone mets than CTs, but even PET results can be ambiguous. In his Bone Metastases in Lung Cancer - An Introduction, Dr. West said:

"Often, those scans still can’t definitely proclaim an abnormal area as cancer. MRI scans are often very, very good at determining details of bony disease and clarifying whether an abnormality is cancer or degenerative changes." - http://cancergrace.org/lung/2007/02/17/bone-metastases-in-lung-cancer-an...

You should have better answers when the MRI results are in.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

Dr West
Yes, an MRI is often very

Yes, an MRI is often very helpful for assessing ambiguous spinal findings. Benign degenerative changes are common, and PET scans will pick up either as mildly PET-avid.

Importantly, the MRI may or may not provide significant reassurance or increased suspicion, but it may still remain ambiguous. In that case, a biopsy or further time for the spot to "declare itself" will be the most fruitful way to clarify what's happening.

Good luck.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Medical Oncologist
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education