My first follow up scan after treatment will be the first week in August and I will have blood work and a CT scan. I noticed others have a PET/CT. Just wondering which is preferred and why.

Steve, not everyone gets a PET scan. They are very expensive. Ive heard a PET can cost several thousand dollars while a CT is only a couple hundred. I think in other countries the CT is more common.

Ive had both done and my doc said for my follow up a CT w/ contrast is enough for my situation.

Hi Steve,
Welcome to OCF. I can not articulate the technical merits of either other than to say a PET/CT is both a CT and a PET scan, two scans. So I would venture to say having both types of scans to review the progress is better in the hands of those who know how to read each.

My understanding of the CT done during PET/CT is not as clear and useful as the standalone CT. Someone mentioned the reason why but that eludes me now.

Best for your scans. I am due end of this month too for first set.

don

As mentioned, cost is one factor. A CT is easier to read, and doesn't need specialized training like a PET, no specialized diet, fasting, so is the most often utilized scsn. I had about 11 PET/CT scans, some costing $6,000. It also depends what the doctor wants to view, area, to indicate which diagnostic test to use, sometimes multiple ones. CT is also good to highlight bone involvement, MRI for vessels, nerve line involvement, and a PET/ CT for distance metastases, and lymph nodes. I also had an MRI's followed by a PET/CT due to tooth filling scatter. I read that the most accurate is the PET/CT, down to as small as 5mm, then the MRI, followed by CT. PET also has a high rate of false positives. Some say it's 90% accurate at 8 weeks, 3 months is the most often taken, 4 months is better, and at a year is 100% accurate. I had most scans done at 3 months, and two at 5 months, 8 months post treatment for various reasons, and that's long waiting.

I'm also have a scheduled for a PET/CT in August, without CT contrast, due to the kidneys. At first my ENT was scheduling a CT, but I needed the nephrologist's clearance, and in between my RO, who specialises in HNC, said I need to get a PET/CT, and that is what I'm having. Personally, I would rather have a PET/CT, and If needed, another test to follow to highlight the area they want to view, as Don mentioned, I don't think it as good in a PET vs stand alone CT.

Good luck with your scan.

Steve, I asked my doc about this as I had a false positive on nodes for my pre-surgery PET. My neck was like a Christmas tree on the PET, but none of the nodes came back positive at surgery.

He said he prefers the CT with contrast as all my scopes are coming back clear, but offered the PET if I wanted it. I was actually more worried about another false positive, so I'm going to stick with the CT.

I was treated at Moffitt a CCC and I only had 1 PET and that was pre Tx. Post Tx I had 3 CT's and that was because I had spots on my lungs so I had one every 3 months post Tx until they were gone.

David,
Don't mean to pull this thread OT but what's the story on spots on lungs? I have a couple small and low SUV spots which after a lot of hemming and hawing was never fully diagnosed, just in wait and watch mode. don

Thanks everyone it is nice to get the feed back. I am going to a CCC (M.D.Anderson) and trust that they know what they are doing. At the same time the more I understand and am informed about some of these issues the better I feel about what's going on to be able to self advocate when needed.

MD Anderson is the number one cancer center in the country, according to U.S. News Report Best Hospitals 2013. I would say you are in good hands.

Don,

The 1st post Tx scan report came back showing 2 spots in the upper part of one lung (I forget which side) with the verbiage "areas that cannot be excluded." My RO who during Tx had already shared with me that if my cancer spread to my lungs or brain I was dead, told me and my wife "don't worry". Yeah right, so he agreed to schedule another scan in 3 months. THREE LONG MONTHS and another scan and this time the first set of spots were "resolved" but there were new spots in the lower part of the same lung which the same verbiage "areas that cannot be excluded." RO again said "don't worry." Yeah right so he agreed to do another scan in 3 months. THREE LONG MONTHS and finally I got an all clear. RO surmised spots must have been inflammation from the Tx.

Thanks David,

Just have to keep on moving forward but sure unsettling to have that gray cloud always over your/my head. Guess there is not much to do.

In my case, they were there on the first PET and CT and then on a CT after induction chemo that declared "near or complete response". Since the spots were still there the logic goes probably not same cancer as they would have likely disappeared. So good news in an inverse way. Pulomonlogists newer did figure it out.

Next PET/CT coming in a few weeks. will be interesting to say the least. don

Talked with my RO today about CT vs PET/CT on my first check up and the concern was false positives so close to treatment as Tina had suggested. I may have a PET/CT on the 3 month follow up but the first would be CT with contrast.

Good luck Steve...gotta love the "don't worry". My RO said that to me, and I said "if it was your sister sitting in my place would you be worried?". He looked rather chagrined and then said he would try to stop saying that.

Amazing how some really smart people can be really dumb sometimes.