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Normal FDG PET/CT Report Template (Skull Base to Mid-Thigh)
Normal FDG PET/CT report template: blood glucose, dose and uptake time, physiologic distribution list, no hypermetabolic disease region by region, mediastinal blood pool and liver reference SUV, with notes on Deauville, brown fat and SUV reporting.
EXAMINATION: FDG PET/CT, skull base to mid-thigh. CLINICAL HISTORY: [indication, e.g. “Initial staging of non-small cell lung cancer” / “Restaging of lymphoma after chemotherapy”] COMPARISON: None available. TECHNIQUE: Following a fast of at least [6] hours, the serum glucose was [x] mg/dL. [x] mCi of F-18 fluorodeoxyglucose was administered intravenously, and PET images were acquired from the skull base to the mid-thigh after an uptake period of [x] minutes. A low-dose, non-contrast CT was obtained for attenuation correction and anatomic localization [and is not of diagnostic quality for soft tissue evaluation]. Images were reviewed in axial, coronal and sagittal planes with fused PET/CT and maximum-intensity-projection images. Reference activity: mediastinal blood pool SUVmax [x]; liver SUVmean [x]. FINDINGS: Physiologic distribution: Physiologic FDG uptake in the brain, Waldeyer's ring and salivary glands, myocardium, liver and spleen, gastrointestinal tract, renal collecting systems, ureters and urinary bladder, bone marrow, and skeletal muscle. [Physiologic uptake in brown adipose tissue of the supraclavicular and paraspinal regions. / Physiologic uterine and ovarian uptake, menstrual phase.] No hypermetabolic focus outside the physiologic distribution. Head and neck: No hypermetabolic lesion in the visualized skull base, oropharynx, larynx or thyroid. No hypermetabolic cervical lymph node. Chest: No hypermetabolic pulmonary nodule or mass. No hypermetabolic mediastinal, hilar or axillary lymph node. No pleural effusion or pleural nodularity. The lungs are clear on the CT component. Abdomen and pelvis: No hypermetabolic hepatic, splenic, adrenal or pancreatic lesion. Physiologic bowel activity without a focal hypermetabolic lesion. No hypermetabolic abdominal, retroperitoneal, pelvic or inguinal lymph node. No ascites. Musculoskeletal: Normal, homogeneous marrow uptake without a focal hypermetabolic osseous lesion. No lytic or sclerotic lesion on the CT component. Incidental CT findings: [None.] IMPRESSION: 1. No FDG-avid disease from the skull base to the mid-thigh. 2. Physiologic FDG distribution. No hypermetabolic lymphadenopathy or focal hypermetabolic lesion.
Dictation notes
- The technique line carries the quality of the whole study: serum glucose, injected dose, uptake time and whether the CT was diagnostic or low-dose — a glucose above 200 mg/dL or a 45-minute versus 90-minute uptake changes the SUV, and a lesion that is called resolved on a 60-minute scan after a 90-minute baseline is a timing artifact.
- Give the mediastinal blood pool and liver reference values; Deauville scores in lymphoma (1 no uptake, 2 at or below mediastinum, 3 above mediastinum but at or below liver, 4 moderately above liver, 5 markedly above liver or new lesions) are defined against them, and the end-of-treatment score is the report.
- Brown fat, laryngeal muscle after talking, injected-extremity muscle, bowel in metformin patients, and the thymus in young patients are the common physiologic traps; name the one that is present so the next reader does not call it disease.
- Report an SUVmax for the index lesion with its location and size from the CT component, and compare to the prior with the same metric; a 30% rise or fall is the PERCIST-grade change, and a focal thyroid nodule with uptake is malignant in about a third of cases and gets an ultrasound.
- The low-dose CT is read: incidental lung nodules, aortic aneurysm, adrenal nodules and renal masses are reported with their follow-up recommendation, with the caveat that the CT was non-contrast and low-dose.
Related references
Fleischner pulmonary nodule follow-up · Adrenal washout calculator
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