PET CT scan

A listener sent in their medical records for help deciphering them. The records include a PSMA PTT scan and lab results. PSMA PTT is an imaging technique that uses a radioactive tracer to detect prostate cancer cells. The tracer targets the prostate and emits a signal that the scanner can detect, creating an image. The CT part of the scan provides anatomical details. The scan used a standard dose of gallium 68 gazetatide as the tracer. The lab results show an elevated PSA level, which can be a sign of prostate cancer but not a definitive diagnosis. Physiologic uptake in organs like the liver and kidneys is normal. SUV values measure tracer concentration, and a higher SUV indicates more activity. The scan found intense tracer uptake in the prostate, particularly in the left peripheral zone, but no evidence of cancer spread. A previous MRI scan was also mentioned for comparison. It is important to consult with a physician for a proper diagnosis and treatment plan. All right, everybody, welcome back to the Deep Dive. It's great to be here. We're diving into something a little different today. Yeah, something pretty personal. We got some medical records sent in from a listener. Right. And they want a little help deciphering them. Yeah, makes sense of it all. So specifically, we have a PSMA PTT scan. Ooh. And some lab results. All right. So let's just jump right in. Let's do it. So first up, what does a PSMA PTT stand? Yeah, so PSMA stands for Prostate Specific Membrane Antigen. And basically, it's a type of imaging that looks for prostate cancer cells. And it does that by using a radioactive tracer. Oh, wow, a radioactive tracer. So what is that? So a radioactive tracer is basically like a little tiny amount of radioactive material that's attached to a molecule that specifically targets the prostate. So it goes right to the prostate. Exactly. And the scanner can pick that up. Yeah, so the tracer emits a signal that the PE scanner can detect. And it creates an image showing where the tracer has accumulated. So it's like lighting up the prostate, essentially. Exactly, yeah. It highlights the areas where the tracer is concentrated. And that can help identify potential areas of concern. Wow, that's really interesting. Yeah, and then the CT part of the scan provides a detailed anatomical picture. So you get both the functional information from the PT and the structural information from the CT. So it's like a two-for-one deal. Exactly. Yeah, it gives a really comprehensive view. Oh, that's fantastic. And I see here that this particular scan used 3.56 millicuries of gallium 68 gazetatide. Right. So that was the tracer. Yeah, that's the specific radioactive tracer used in this case. And that's a pretty standard dose for this type of scan. OK, great. And along with the scan results, we also have this lab work showing a PSA level of 8.8 nanograms per milliliter. So what is PSA? So PSA stands for prostate-specific antigen. And it's a protein produced by the prostate gland. And when the PSA level is elevated, it can be a sign of prostate cancer. But it's important to note that an elevated PSA doesn't always mean cancer. There are other things that can cause it, like an enlarged prostate or inflammation. So it's like a red flag? Yeah, it's a signal that something might be going on. But not a diagnosis. Exactly right. OK, so not to panic yet. No, not at all. All right, so let's dive into the actual scan findings. OK. So I'm seeing here a lot of mentions of physiologic uptake in various organs, like the liver kidneys and salivary glands. Right. What does that mean? So that's actually totally normal. It just means that the tracer is being processed and eliminated by the body. Those organs are naturally involved in filtering and excreting substances. So it's expected to see some uptake there. So that's not a cause for concern? No, not at all. That's good to know. OK, and then I'm also seeing these SUV values mentioned for different areas. Yeah. What are those? So SUV stands for standardized uptake value. And it's basically a measure of how much tracer is concentrated in a particular area. OK. So a higher SUV generally means there's more tracer activity in that spot. Got it. OK. And I see a higher SUV in the submandibular gland compared to the parotid gland. Right. Is that significant? You know, it's an interesting observation. But in this context, it's not necessarily a cause for concern. It could just be a normal variation. OK, that makes sense. Yeah. All right, so let's get to the abdomen and pelvis. What's going on there? So the report mentions two focal areas of intense tracer uptake in the prostate gland, particularly in the left peripheral zone. And the SUV max in that area is 64.9, which is significantly higher than the SUV of 15.8 in the right peripheral zone. So that's the index lesion I'm seeing mentioned here. Exactly, yeah. The index lesion refers to the area with the most intense tracer uptake. OK, and that's concerning. Right. It's definitely something to pay close attention to. But it's important to look at the whole picture. And one good thing is that there's no mention of hypermetabolic lymph nodes. Right, I see that here. Which is a good sign, because lymph nodes are often the first place that prostate cancer spreads to. So if they were lighting up, that would be bad news. Exactly, yeah. So the fact that they're not is encouraging. OK, so that brings us to the impression section, which states that there are two focal areas of PSMA uptake in the prostate gland. But there are no findings to suggest metastasis. Right. That seems to support what we were just talking about. Yeah, exactly. It suggests that the cancer, if it is cancer, may be localized to the prostate. OK, and then I see a mention of a previous MR prostate scan from August 23, 2024. Yes. So why is that important? So comparing the current scan to the previous one can help assess any changes or progression over time. Got it. So it's like looking at a before and after picture. Exactly, yeah. It helps to see the bigger picture. OK, so to sum it all up, it looks like we have an elevated PSA level. Two areas of intense uptake in the prostate, but no evidence of spread at this point. Yeah, that's a good summary. But of course, this is just one report. And it's crucial to consult with a physician for a proper diagnosis and treatment plan. This is just a piece of the puzzle. Yeah, exactly. So don't take this as medical advice. No, no, no, no, no. This is just for informational purposes. Right. Always talk to your doctor. Yes, always. But hopefully, this gives you a better understanding of your results. Exactly, knowledge is power. It is. And it's amazing how this PSMA technology can pinpoint these potential problem areas. Yeah, it's really remarkable. I wonder what other applications this could have in the future. Oh, I'm sure there are many possibilities. Yeah, it's really exciting stuff. Absolutely. So that's it for today's deep dive. We'll see you next time. See ya. Keep on learning, everybody. Bye.