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*   PET Oncologic
*   http://www.radreport.org/template/0000082	


Type: Reporting template
Language: English (en)
Modified date: 2012-07-19
Creator: Pryma DA, et al.
Contributor: Hong Y [coder]
Contributor: Kahn CE Jr [editor]
	
This file is part of the "RSNA Radiology Reporting Templates."

The RSNA Radiology Reporting Templates are licensed without charge under
the RSNA's license agreement (the "License"); you may not use this file
except in compliance with the License (http://www.radreport.org/license.pdf).

Unless required by applicable law or agreed to in writing, software
distributed under the License is distributed on an "AS IS" BASIS, WITHOUT
WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.

See the License for the specific language governing permissions and
limitations under the License.

Copyright (c) 2013, Radiological Society of North America, Inc. (RSNA)
ALL RIGHTS RESERVED

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POSITRON EMISSION TOMOGRAPHY WITHOUT COMPUTED TOMOGRAPHY – ONCOLOGIC

CLINICAL INDICATION:

Diagnosis: [Lung nodule | Lung cancer | Head & Neck cancer | Thyroid cancer | 
Esophageal cancer | Breast cancer | Colorectal cancer | Uterine body cancer | 
Uterine cervix cancer | Ovarian cancer | Lymphoma | Malignant Melanoma]

Indication: [Initial antitumor treatment strategy | Subsequent antitumor 
treatment strategy | Diagnosis | Staging | Restaging | Response to therapy ]

{New CMS nomenclature of initial or subsequent antitumor treatment strategy 
may become widely utilized, but currently staging, restaging, etc are 
generally used}

Relevant prior therapies include: [surgery ; chemotherapy; radiotherapy]

COMPARISON:

[ <date> | None* ]

TECHNIQUE:

-Date of PET:	 				[<date>]
-Acquisition time:				[<Acquisition completion time>]
-Location:					[<site>]
-Duration of fast prior to injection: 		[Overnight* | hours]
-Blood glucose prior to injection: 		[<#> mg/dl]

-Scan Region: [<skullbase to proximal thighs | head to toe | limited 
acquisition>]

-Injected Dose 	 			[<#> mCi F-18 FDG]

-Injection site [<right | left>] [<hand | forearm | antecubital | PICC | 
central port]

-Post-injection imaging delay:		[<#> minutes]
-Attenuation Correction:			[<Rod source transmission scan>]
-IV contrast					[none* | ]
-Oral contrast					[none* | ]

FINDINGS:

[No significant hypermetabolic foci.* | ]

[Tracer distribution is otherwise in a normal physiologic distribution.* | ]
 
IMPRESSION:

[No hypermetabolic malignancy.* | Hypermetabolic malignancy in the | Complete 
metabolic response to therapy. | Partial metabolic response to therapy. | 
Progressive metabolic disease. | Stable metabolic disease. ]

{
EORTC Response Criteria:
Complete Metabolic Response. MaxSUV <2.5 or equivalent to background
Partial Metabolic Response. Decrease in MaxSUV >=25%
Progressive Metabolic Disease. Increase in MaxSUV >25%
Stable Metabolic Disease. Change in MaxSUV <25%
}