Saturday 27 October 2007

C/T Scan

Saturday 27/10/2007 - 8:30am.


Attended Dee Why X-Ray & CT facility to undergo a CT (computerised tomography) Scan to determine the possible 'spread' of cancer. The hope is that the cancer is contained to the Prostrate and not spread beyond to the lymph nodes and abdomen.


A 'dye' was injected into a vein to improve the clarity of the scans. The injection caused a feeling of being 'hot all over' for several minutes - which is normal for most people. The scan took about 30 minutes.

You lie flat on a table inside a large and circular device (CT scanner) which rotates around you, alternatively holding your breath while the scans are taken and exhaling while the machine relocates for a subsequent scan.


The Report from the scan was picked up later that same day and was as follows:-

The history of Prostate Cancer staging is noted.

Post contrast scans were performed with dual phase scanning through the liver.

There are multiple low density lesions in the liver, mainly in the left lobe. These are mainly too small to character, the largest measuring 10mm but the two largest lesions are of fluid density consistent with simple cysts.

The adrenals and pancreas appear normal. There are paraplevic cysts bilaterally in the kidneys.

There are two soft tissue nodes lying antetiorly to the spleen, the largest measuring 18mm in diameter. These have similar density to the adjacent spleen and I think most likely represent small splenuncili (as indicated on venous phase scans 21.5 & 25.5).

However, in addition there are multiple small nodular densities spread widely through the mesentery with mild mesenteric hazing. These nodules only measure up to 5mm in diameter but are more widely spread through the mesentery than is typical of normal mesenteric nodes and I think they are suspicious of early metastatic disease.

There are no para-aortic or pelvic lymphadenopathy.

The prostate margins appear rather ill-defined and the seminal vesicles are bilaterally bulky.

Review of thess images on bone windows demonstrates several tiny sclerotic lesions in the bony pelvis suspicious of early mestastases. These are seen bilaterally in the iliac bones, in the right side of the scarum and in the right femoral head as indicated on the hard copy films. The largest lesion measures 7mm in maximum diameter.

Scans through the lung bases show no evidence of pulmonary metastases.


CONCLUSION:

Multiple low density lesions in the liver which are mainly too small to characterise. The largest lesions are of fluid density consistent with small cysts. Follow up scans will provide clarification as to the nature of the other liver lesions.

Appearances suspicious of several tiny bony metastases in the pelvis as described. An isotope bone scan is suggested for further assessment.

Appearances suspicious of early mesenteric lymph node metastases but again follow up scans will provide clarification.

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