I just now got back from my post-treatment PET scan. This one seemed to go faster than the last one, which was very nice.
My appointment was this morning (January 8, 2008) at Miami Valley Hospital, our premier humongous hospital just outside downtown Dayton. My office is about 1/2 mile from here. There is always a lot of activity around the hospital, not necessarily medical-wise...but construction-wise. There is always something under construction here.
Fig. 1: Main Hospital Entry Courtyard
Fig. 2: Orders and ID stickers.
Before the PET scan, they install an IV so they can administer the radioactive glucose. The syringe is a typical plastic syringe, but it is jacketed in a thick, heavy lead liner.
Fig. 3: Nuclear medicine at work.
After getting the radioactive injection, you are left in a comfy recliner for nearly an hour to rest in a darkened room. This is to allow the glucose to spread throughout the body. The idea is that since cancer cells take up sugars quite rapidly, they will take in the radioactive materials. The PET scanner detects the particle emissions of the radioactive material. The greater the concentration of radioactive particles, the more likely the area is cancerous.
This stuff is seriously radioactive. On the way out to where the PET scanner is located, there is a Geiger counter on a little shelf with a sign that instructs employees to check themselves to make sure they aren't "hot". As I passed by, the little machine went bananas.
Fig. 4: The GE Discovery PET/CT Scanner
You lay on a long table, and have a CT scan first. The front 2/3 of the scanner is the CT scanner. The CT spins around an takes x-ray images of thin slices of the body. This gives information as to what is where. The CT takes only about a minute or two.
The PET scan take a lot longer. Strapped down to the same table, you stay aligned just as with the CT scan, then pass through the rear 1/3 of the donut. The PET scan I had today took about 40 minutes. This is because it takes a while for the detectors to receive enough particles. During all of this, you have to remain still. Because they wanted to make absolutely sure of everything, they had to do an additional precision "neck study", which is a slower CT scan to get clearer, more detailed images, then another 20 minutes in the PET scanner.
The scans are then sent to a radiologist that scrutinizes everything. The PET scan is overlaid on the CT scan, so the actual locations of any tumors can be discovered. They will then submit a report to my oncologist.
The hospital's PET scanner is in a trailer outside the hospital, so you have to pass through a tunnel to get there. The machine costs about $1.2 million. I suspect that since the machine is in a trailer, the bank can come and get it real easy if they miss a payment.
Fig. 5a: The front of the "Get Out of Jail Free" card.
Once the procedure is complete, they give you a little card that tells that you received a medical dose of radiation. If I were to go to an airport, the air force base or a Department of Energy facility today (none of which are likely), then I would set off every alarm they have. Without the card they would ship me off straight away to Guantanamo Bay, where I would never be seen or heard from again.
Fig. 5b: The back of the "Get Out of Jail Free" card.
The text in the box on the lower half states:
The radioactive material will be gone by the morning.
18FDG is actually, in scientific jargon, 2-deoxy-2-[18F]-fluoro-D-glucose. Originally developed in the '70s for brain imaging, but discovered to be useful in detection of cancerous cells in the '80s, leading to PET scans being the norm for many cancer patients.
Brookhaven National Laboratory has a short article about "FDG" at http://www.bnl.gov/pet/FDG.htm.
Harvard Medical has a great website that outlined pretty much everything about the PET/CT procedure, located at http://www.med.harvard.edu/JPNM/chetan/.
The radiology techs were amused that I took pictures of everything. They had never had anyone do that before. They were all very nice and friendly, as per usual. The first PET scan I had, I did not know what to expect, and they all made me feel quite at ease. This go around I knew what was going on, so I wasn't apprehensive or nervous and could be a great deal more chatty.
So, I will get the results late next week at my next oncology appointment!
My appointment was this morning (January 8, 2008) at Miami Valley Hospital, our premier humongous hospital just outside downtown Dayton. My office is about 1/2 mile from here. There is always a lot of activity around the hospital, not necessarily medical-wise...but construction-wise. There is always something under construction here.
Fig. 1: Main Hospital Entry CourtyardThey have a pretty good system to get people registered for outpatient procedures. You go to a central registration area and get a pager. Then, when your pager goes off, you are sent to one of fourteen private niches to get your information taken. Then the registrar directs you to where you need to go.
After registering, I made my way to the Medical Imaging department.
After registering, I made my way to the Medical Imaging department.
Fig. 2: Orders and ID stickers.Before the PET scan, they install an IV so they can administer the radioactive glucose. The syringe is a typical plastic syringe, but it is jacketed in a thick, heavy lead liner.
Fig. 3: Nuclear medicine at work.After getting the radioactive injection, you are left in a comfy recliner for nearly an hour to rest in a darkened room. This is to allow the glucose to spread throughout the body. The idea is that since cancer cells take up sugars quite rapidly, they will take in the radioactive materials. The PET scanner detects the particle emissions of the radioactive material. The greater the concentration of radioactive particles, the more likely the area is cancerous.
This stuff is seriously radioactive. On the way out to where the PET scanner is located, there is a Geiger counter on a little shelf with a sign that instructs employees to check themselves to make sure they aren't "hot". As I passed by, the little machine went bananas.
Fig. 4: The GE Discovery PET/CT ScannerYou lay on a long table, and have a CT scan first. The front 2/3 of the scanner is the CT scanner. The CT spins around an takes x-ray images of thin slices of the body. This gives information as to what is where. The CT takes only about a minute or two.
The PET scan take a lot longer. Strapped down to the same table, you stay aligned just as with the CT scan, then pass through the rear 1/3 of the donut. The PET scan I had today took about 40 minutes. This is because it takes a while for the detectors to receive enough particles. During all of this, you have to remain still. Because they wanted to make absolutely sure of everything, they had to do an additional precision "neck study", which is a slower CT scan to get clearer, more detailed images, then another 20 minutes in the PET scanner.
The scans are then sent to a radiologist that scrutinizes everything. The PET scan is overlaid on the CT scan, so the actual locations of any tumors can be discovered. They will then submit a report to my oncologist.
The hospital's PET scanner is in a trailer outside the hospital, so you have to pass through a tunnel to get there. The machine costs about $1.2 million. I suspect that since the machine is in a trailer, the bank can come and get it real easy if they miss a payment.
Fig. 5a: The front of the "Get Out of Jail Free" card.Once the procedure is complete, they give you a little card that tells that you received a medical dose of radiation. If I were to go to an airport, the air force base or a Department of Energy facility today (none of which are likely), then I would set off every alarm they have. Without the card they would ship me off straight away to Guantanamo Bay, where I would never be seen or heard from again.
Fig. 5b: The back of the "Get Out of Jail Free" card.The text in the box on the lower half states:
Michael received a medical dose of radioactive material (18FDG) on 1-8-08. This person poses no risk to the public. The release of this patient is allowed by the U.S. Nuclear Regulatory Commission and meets the required regulations of the State of Ohio. If you have questions, call the Nuclear Medicine Department at (937) 208-2220. This card expires 1-9-08.
The radioactive material will be gone by the morning.
18FDG is actually, in scientific jargon, 2-deoxy-2-[18F]-fluoro-D-glucose. Originally developed in the '70s for brain imaging, but discovered to be useful in detection of cancerous cells in the '80s, leading to PET scans being the norm for many cancer patients.
Brookhaven National Laboratory has a short article about "FDG" at http://www.bnl.gov/pet/FDG.htm.
Harvard Medical has a great website that outlined pretty much everything about the PET/CT procedure, located at http://www.med.harvard.edu/JPNM/chetan/.
The radiology techs were amused that I took pictures of everything. They had never had anyone do that before. They were all very nice and friendly, as per usual. The first PET scan I had, I did not know what to expect, and they all made me feel quite at ease. This go around I knew what was going on, so I wasn't apprehensive or nervous and could be a great deal more chatty.
So, I will get the results late next week at my next oncology appointment!
2 comments:
This was all very interesting to know from the viewpoint of someone who has never had such treatment, but it all sounds very scary.
Personally, I'm not sure I could sit still for 10 minutes, let alone 40+. How do you manage it?
I had to laugh at the Guantanamo joke ...until I realized it isn't really a joke in George Bush's America. :-p
Here's hoping your test results are clean!
It really isn't as scary as one would think. If you are strong, which I am not, and have good doctors, there is no reason to be afraid.
I really can't sit still, either, so don't feel bad. I try to think about it like it is another opportunity to take a nap! LOL! They covered me with blankets, and I had a pillow while in the machine.
Plus it helps to think of the machine as a giant Krispie Kreme.
And the joke...well, it really is no joke, but it is somewhat funny in a Orwellesque kinda way. I am loathe to talk politics, but while the liberation of Iraq was long in coming and a good thing in the end, GW has been a terrible president. GW senior should have taken care of business back in '91...
My jaw is starting to feel much better with the arthritis meds I am on, so I am very hopeful that things will work out.
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