2024-01-17 19:49:22
January 18, 2024
Dr. Huang Qiongying
Take a breath
The cardiologist called: “Grandpa Chen has heart disease. During a routine examination, he found a shadow in the right upper lung, 2 centimeters in size. The positron emission tomography (PET-CT) report said it was mostly tumors. Please prepare for a bronchoscopy. His heart function has declined and he cannot withstand major surgery. He needs to be diagnosed as early as possible so that the oncologist can arrange appropriate treatment.” The bronchoscopy did not find cancer cells, only a slight inflammation reaction, and the nucleic acid test found the tuberculosis gene, so I told the cardiologist Doctor, Grandpa Chen has tuberculosis and needs to take tuberculosis medicine. The cardiologist was shocked: “The PET-CT report is clearly a tumor, might it be a false negative?” “His tuberculosis is not under control, so he is not suitable for any chemotherapy for lung cancer. Treat the tuberculosis first!”
The cardiologist was under tremendous pressure from his family and was afraid that it would delay Grandpa Chen’s treatment of the “tumor”, so he contacted the radiologist and discussed using computer scan guidance to extract the shadowed lung tissue through skin puncture for testing. The radiologist said that the shadow was The location is blocked by bone and large blood vessels, making it technically impossible. I suggested checking him once more following two months, using magnetic navigation and intratracheal ultrasound to increase accuracy. The results of the checkup two months later still showed no cancer cells. Half a year later, the X-rays of his lungs showed slight improvement. After completing 9 months of drug treatment for tuberculosis, Grandpa Chen underwent another positron scan, which confirmed that the shadows on his lungs had shrunk, his metabolic rate had dropped significantly, and there was no cancer. Only scars from tuberculosis remained. Friends from the cardiology department might breathe a sigh of relief.
PET-CT is used to diagnose cancer and other diseases. For example, following lung cancer is diagnosed, we can use PET-CT to define the stage. The method is to inject glucose with radioactive isotopes. The glucose will be absorbed by the cells of the body and focused on areas with particularly fast metabolism. By scanning the signals emitted by the radioactive isotopes, the location of the tumor can be reflected. Measuring the uptake value (SUV) of radioactive isotopes, it is speculated that the uptake value of pathogens, such as scars, is very low or even 0, the uptake value of malignant tumors is very high, and the uptake value in the middle level is a gray area… (To be continued)
The author is a respiratory system specialist
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