Friday, October 03, 2014

spect/ct

After this infinitely long week, I had my whole body scan today.  I have a new nuclear medicine doctor, who works in the same practice as Dr. S.  I have the impression Dr. L has retired or moved on in some other way, since his card was not available in the reception area.

Dr. Y was, at first, pleased with my scan and said it was clean.  Then she asked me about my Tg and my history and when I explained she paused for a moment and pointed me to a faint spot somewhere in my chest.  "I thought it could be thymus activity," she said, explaining that's common for younger people, and not unheard-of for 50-somethings like me. "But given your history, I want you to have a spect/ct scan so we can try to get a better look at where that is."

This was new for me. I asked the technician many questions, and he was very nice and forthcoming about discussing it with me.  The spect/ct picks up the same RAI emissions as the WBS does, but it combines them with ct data to give a three-dimension image.   For comparison, here's a WBS image: 

 

You can see that it's basically a pointilist, 2-dimensional collection of I-131 emissions.  The image below is the monitor from a combined PET/CT and SPECT/CT scanner.  It constructs a 3-dimensional view that you can drill through, combining structural data with the emissions information from that same RAI. 

http://www.healthcare.philips.com/pwc_hc/main/shared/Assets/Images/NuclearMedicine/PET/Product/ig_PET_CT-Viewer_lrg.jpg 

I don't remember if my hospital had this exact scanner, but the display was very similar.  You can do cross-sections both height- and width-wise (transverse and sagital views, I think...) and you zoom in and out.  There is a truly astonishing amount of data there.

Nothing really leaped out at us in our quick once-over - of course, neither of us are trained to read these things, but the tech has a lot more experience than I do.  He zoomed around a bit and found a spot in my upper left chest and we thought that might be it, so he went over to his other monitor and pulled up my whole body scan image and we compared the location of the faint spot there to the location of the bright spot on the spect/ct.  Our consensus was that was probably the troublesome area, and it appeared that there is some activity there.  It was an anomolous green spot on the display, but not very bright.   But considering we didn't see green literally anywhere else, I tend to think that was it, but it was really hard to tell where it was, and it was impossible to say what it means. (I wish I had had the foresight to snap a couple of photos with my phone, but I don't know if that would've been allowed.)

We called Dr. Y as she had gone to another department at the hospital, and she took my number and said she would call me this afternoon.  That was four hours ago, and I still haven't heard, and I feel like a complete idiot because I forgot to ask if I could go off the LID!

Odds are we aren't going to do anything right away anyway, but I'd rather have RAI than surgery so I'm thinking it's smart to keep that option open. So I'm still on the LID for now, even though I would really like to go to Joyride and get their trio of different seafood tacos that are so incredibly delicious.

I am so making jambalaya when I finally get off this diet!