There are many different types of tests or scans which involve imaging . At first in 1998, I had CT’s done every 3 months for years.
Computed Tomography (CT)
- A CT scanner uses X-rays and massive computer processing to image the chest and abdomen in cross sectional slices. CT can detect intrathoracic sites of disease not detected on chest X-ray in up to 20% of patients. However, CT can not distinguish between scar tissue left after treatment and active disease. I have a whole body CT done now yearly. Head to toe, adding on both arms, and left leg and leg ankle. So, it is for me, Head, Neck, Chest, Adom, Pelvis, both arms, left leg & left ankle. In order to increase the quality of the images patients are often required to drink contrast fluid (yummy Barium) and iodine dye is injected into a vein during the scan.CT’s are not really that bad, just for me they break it into 2 sessions since, they added my brain. I overdosed once with the iodine and got very sick. My employer at the time, didn’t quite undertand when I needed the week off and I lost my job.
- Knowledge is power and I wish people would take the time to learn more about illnesses because discrimination does occur for people with chronic illnesses. I was actually asked by that employer if I felt I was special and he fired me for needing the time off. It happens.
- MRI’s are not one of my favorites.
Magnetic Resonance Imaging (MRI)
- On MRI, lymphoma typically demonstrates a homogeneous low signal intensity similar to muscle on T1 images, and high (greater than fat) or mixed signal on T2.
- I don’t mind what is called, open MRI’s but the enclosed MRI’S can cause alittle bit of anguish in some. The magnet is alittle bit stronger in the full enclosed one but my oncologist & neurosurgeon is okay with both.
- I found a trick with the full MRI which is to make sure the tech’s place a cloth over your eyes before going in. The reason for this I really do think is to trick the mind into thinking if you were to open your eyes while in there, you are only seeing the cloth and not the machine which does sit pretty low down to your face. I also, wear head phones and the ” beating” of the machine then becomes part of the music I am listening to. I am now yearly on MRI’s of my brain. I have 3 brain tumors which we keep an eye on. They are inoperable. No one ever promised me a rose garden.
- and then we have:
Positron Emission Tomography (PET)
- FDG-PET is a noninvasive imaging method which may contribute to improve the staging with HD, particularly by detecting previously unknown lesions in spleen and bone marrow. Equipment consists of scanner, computer and cyclotron.Glucose uptake increases in cancer when cell proliferation is in progress. FDG (2-deoxy-2-(18F)fluoro-deoxyglucose) is a radioactive glucose analog.PET imaging has demonstrated high sensitivity for the detection of abnormal lymph nodes in patients with lymphoma. There were false positives associated with inflammatory lymph nodes.Lack of FDG uptake in residual masses four weeks after completion of treatment may predict high probability of long term disease-free survival.I get this done with the CT’s, twice a year every 6 months. It is called, CT/PET Scans. There are dietary restrictions prior to the exam; while waiting to start the procedure it is important to sit in the dark. Light uptakes glucose. It is important if you do not know this or understand this and you find your tech not sitting you in a darkened area to mention it to the tech.
- Lymphangiogram
- This test gives a very accurate picture of abdominal and pelvic lymph involvement. It is a long and uncomfortable procedure involving the injection of dye into the skin of the feet to show up the lymphatics using X-ray imaging.
Bone marrow biopsy (BMB)
- In adults, the sample is usually taken from the pelvic bone. With the patient lying on his/her stomach, the skin over the biopsy site is deadened with a local anesthetic. The needle is then inserted deeper to deaden the surface membrane covering the bone. A larger rigid needle with a very sharp point is then introduced into the marrow space. A syringe is attached to the needle and suction is applied. The marrow cells are then drawn into the syringe. This suction step is occasionally uncomfortable, since it is impossible to deaden the inside of the bone. The contents of the syringe, which to the naked eye looks like blood with tiny chunks of fat floating around in it, is the bone marrow sample.This part of procedure, the aspiration, is usually followed by the core biopsy, in which a slightly larger needle is used to extract core of bone. The calcium is removed from the bone to make it soft, the tissue is processed and tissue sections are made. Even though the core biopsy procedure involves a bigger needle, it is usually less painful than the aspiration.I have had this done numerous times and survived, but it isn’t fun.
- MUGA Scan
- Essentially what happens is they inject a very low level radioactive material which sticks to the muscles of your heart and spleen. From this point they use a machine that reads radiation to measure the amount of blood your heart pumps (also know as ejection fraction). The reason for this test is to ensure your heart muscle has not been damaged too much by Adriamycin. All in all the test is painless and only takes about 15 minutes. What is really cool is that you get to watch the test happen right in front of you because the technicians don’t need to leave the room because the radiation levels are not that high. I have actually fallen sleep during this.
Gallium Scan
Basically a gallium scan is used to identify places which may indicate active cancer. This is done by giving the patient an injection of a radioactive material and then scanning the body a day or two later. Spots which “light up” tend to indicate cancer. The scan is useful when done prior to treatment and then again at the end of treatment. If the scan shows activity before treatment, but shows no activity after treatment, there is a good possibility that the treatment has eradicated the cancer. However, gallium scans can show both false positives and false negatives. It’s a potentially useful tool, particularly if you are likely to have substantial scar tissue remaining at the end of treatment. In this case (assuming your disease was “gallium avid”) you can use the post-treatment test to see if there is any activity within the scar tissue.
Gallium / Thallium scan (Scintigraphy
- Gallium scans are used in some centers if mediastinal or hilar nodes are involved and as a baseline in patients with bulky disease for better determination of response during or after therapy.In general, Gallium scans often are used to diagnose and follow the progression of tumors or infections. Gallium scans also can be used to evaluate the heart, lungs, or any other organ that may be involved with inflammatory disease.What does a gallium scan entail? A gallium scan requires at least two visits to the Nuclear Medicine Department. On the first day, you will receive an injection in a vein in your arm. Your visit should take about fifteen minutes and the injection will cause no more discomfort than having blood drawn. The injection is slightly radioactive. Some nuclear medicine technicians recommend that you stay a few feet away from children for the first 48 hours after injection.
You will be scheduled to return for imaging between two and five days later. Your scan(s) is the longest part of the procedure and may take up to two hours. For most gallium scans, you will lie on a stretcher or imaging table with the camera positioned above or below you. Multiple images may be taken, or the camera may move slowly, scanning the entire length of your body. A SPECT (tomographic) study may be done to look at a particular area of your body in detail. This involves lying on a narrow imaging table while the camera rotates 360 degrees around you.
Many centers do a delayed scan 5-7 days after the initial scan. This delayed scan is usually better for viewing the abdomen area. The bowel has a high concentration of gallium during the initial scan and can mask a tumor. Some centers utilize food restrictions and enemas to address this problem.