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Suffering from CA colon. Hemicolectomy, 6 cycle of chemotherapy done. Obtained PET/CT report. What does it indicate?

My father is suffering from CA Colon...Hemicolectomy was done on april 20th 2012 and 6cycle of chemotherapy is done. Now in Pet CT report they have given the following findings. Will you please tell me this means ....
FDG avid (SUV max 7.4) focal lesion is seen in segmet VII of right lobe of liver measuring 3.0(cc)x3.0(ap)x4.2(tr)cm. the lesion is extending upto the subcapsular region.In addition,FDG avid (SUV max 4.26) smaller focal lesion measuring 1.2x1.0 cm is seen in segment VI of right lobe.
No other focus of abnormal 18FDG concentration is seen.
Rest of the scan shows physiological distribution of 18FDG.
Fibrosis with volume loss and adjacent tractional bronchiectaticchanges are seen in upper lobe and right middle lobe.
Fibrosis are also noted in lingular segment of left upper lobe and right middle lobe.
Focal ground glass and peribronchovascular infiltrates are seen in lower lobe of left lung.
REplaced right hepatic artery arising from SMA is seen.
Post right Hemicolectomy apopearence is seen.

CA colon, Post operative, Post Chemotherapy
impression has come that metabolically active miltiple at least two focal lesions in right lobe of liver
no other metabolically active disease in present scan
Asked On : Thu, 25 Apr 2013
Answers:  2 Views:  20
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Radiologist 's  Response

PET CT is used to detect highly metabolic lesions in the body. Tumor cells are fast growing and have high metabolic activity and thus, show high uptake on PET CT. Considering that your father has a history of Ca Colon, the lesions within the liver are likely to represent metastases (spread of disease) to the liver. The high SUV value supports this (usual cut-off taken is SUV = 2.5). Your father may require a second line of chemotherapy or other treatment options. You need to consult your oncologist at the earliest.

Fibrotic lesions within the lungs may probably be a sequelae to some old infection and need not be a cause of worry.

Answered: Thu, 25 Apr 2013
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Gastroenterologist Dr. Charles S Narasi's  Response
Hello, sarbanidasghosh,
Thank you for contacting HCM with your quiery.
The findings on the PET scan shows that the cancer has spread
to the liver and at least they see two spots or growths.
His lungs show some scar tissue probably from previous
infections such as pnemonia , bronchitis etc.
The cancer is contained in the right lobe of the liver
and there are treatment options. If the lesions do not shrink
or disappear with chemotherapy , he may have to have surgery
for removal of the affected part of the liver. Liver can regenerate
even if only half of it is normal.
I am sure that the surgeon and the oncologist will discuss all the
options with your father.
I wish him the very best.
Answered: Thu, 25 Apr 2013
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