How many of you have gotten PET scans in addition to MRI's? The hot topic at RSNA (Radiological Society of North America) convention this year was that the PET scan can change the treatment regimen by 20-80% because MRI's miss some things.
UCSF radiation oncology wouldn't accept me for consultation until I could bring one in. The second big topic at RSNA was IMRT.

My husband has never had a PET scan. Although we inquired about it at MD Anderson on one of our follow ups. They told us unless something shows up on cat scan that is questionable, they don't do PET scans. We really wanted one, but they said no. We just had our two and half year check up two weeks ago though and everything looks great, so we are very excited about that.
Julie

My cousin is a well known and highly regarded radiologist in town ( Houston ) who recently retired from one of our best hospitals ( St. Lukes ) and is opening a chain of Imaging clinics. He and one of my best friends who is a radiologist too, tell me I should get a PET scan. Yet when I talk to my radiation oncologist at M.D. Anderson, he pooh poohs it, suggesting that PET scans give confusing results that lead to unnecessary interventions.
What is the truth here?

Danny G.

Hello I am Bobbie Jensen a caregiver and my husband has had two PET Scans since the onset of his cancer stage iv in the back of the tougue and mastized in the lymphnodes by his juglar vein. I really do not see the need but his ono believes in them but does says they are new and sometimes do not pick up what the MRI does if they are not read right. So he has had the Pet Scans since July and one in November after radiation and chemo was done. Yesterday he went for a Biopsy under the tumor that was shrunk because his scan still lit up so will see on Monday what that brings are praying everything is ok and it was scar tissue. I pray for all of you and read all of your issues and it really helps alot thanks

Hi Gary,

I read your posting with great interest since I am being treated at UCSF, but did not have a PET scan; I only had chest x-rays and an MRI. I will bring up the topic at my next check-up.

I am also interested in finding out more about the diagnostic abilities of PET scans in the detedtion of oral cancer in addition to MRIs.
There appear to be no clear guidelines on whether to do Pets.

Does anyone have more information on the topic of PET scans as an additional diagnostic tool? How often are follow-up MRIs and x-rays recommended after treatment?

There is information in the main body of the web site at these two locations about pet scans, they answer some of the questions posted here. Use the search engine in the main site and the 2nd engine on the message board to look for your questions, and frequently you will find it is already answered somewhere.

http://www.oralcancerfoundation.org/diagnosis.htm
http://www.oralcancerfoundation.org/news/news5.htm

The issue with PETs is that they do not find cancer, they find cells that are rapidly metabolizing sugar. This happens when cells are dividing. When you get a bunch of them close together that are metabolizing lots of sugar, that COULD be cancer since one of the characteristics of cancer cells is that they reproduce faster than normal cells, burning more sugar in the process. When a PET finds something like this, the only thing the doctors can do is do a secondary procedure like a biopsy, surgically perhaps, to actually get some of these cells to look at in the pathology lab. If you have a metastasis from oral cancer, even to the cervical nodes, there is the POSSIBILITY that those cancer cells, which now have access to anywhere your lymphatic system goes, could be somewhere else in your body as well. A PET will turn up likely areas to explore further. It will not find cancer per se, just places that deserve a closer examination. Please note, that even a CT scan or and MRI do not diagnose cancer as I have said before. They only find masses of tissue that may be cancer... masses detected by imaging techniques can be benign tumors, cysts, etc., as well as the big C itself.

Thanks for all of your responses! I understand that PET scans are also around $4,000.00 ea whereas a MRT or CT is around $1,000.00. Since UCSF is rated 7th in the country, there is probably a good reason why they require it (but actually my oncologist at Kaiser ordered it). I will ask when I go in for consultation on Friday.
One would have to wonder if it's not a bottom line issue. IMRT is also something that I had to fight for. They were ready to give me the "shotgun" approach when I brought it to their attention. You really DO have to be your own advocate!

More PET info: I may have been off on the cost - I have heard up to $8,000.00 for a scan. This info is from: http://www.vh.org/adult/provider/surgery/EsophagealCarcinoma/05Squamous.html

Brenton L. Harris, B.A.
Kemp H. Kernstine, M.D.
Peer Review Status: Internally Peer Reviewed
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Distant metastases can be evaluated by PET, CT, ultrasound, laparoscopy, or bronchoscopy, depending upon the location and size of the metastases.
The best technology today, outside of invasive surgical staging for distant metastases, is PET. PET is 88% sensitive, 93% specific and 71-91% accurate for identifying distant metastasis. Overall, PET can identify distant metastases in up to 20% of patients that received negative diagnosis with conventional staging.

I had a PET scan from my chest down at a hospital in Philadelphia in July 2001. Cost was either $2200 or $2500 and was covered by insurance with a letter of medical necessity. I requested the scan as I was about to have a total laryngectomy and didn't want to undergo the procedure only to find out that I had cancer of liver or bladder or something worse. The reassurance was worth it. I would have had the scan even if the insurance didn't cover it.

Eileen

Update! Got mine (PET) yesterday morning and it ONLY showed the tumor on my tonsil - No other hot spots, lymph nodes, etc. It verified the data from the MRI.